病人自控镇痛预防消化道肿瘤术后疼痛的效果评估

目的：比较病人自控镇痛（PCA），肌注镇痛（MIA）和直肠给药镇痛（RAA）在消化道肿瘤术后镇痛中的临床效果。方法：将144例消化道肿瘤术后病人随机分为PCA组，MIA组和RAA组。结果：PCA组镇痛效果优于MIA组和RAA组（P＜0．01），24小时患睡眠时间显长于MIA组和RAA组（P＜0．01），肠蠕动恢复和肛门排气时间亦较后二组明显缩短（P＜0．05），术后PCA组血清皮质醇，血糖上升幅度显低于MIA组和RAA组（P＜0．01），术后不良反应的发生，三组无显性差异（P＜0．05）。结论：PCA具有较好的镇痛效果，抑制术后应激反应，减轻内分泌变化。

Evaluation of patient-controlled analgesia in preventing postoperative ache of gastrointestinal-cancer

Objective:To compare the clinical analgesia efficacy and side-effect of patient controlled analgesia(PCA)with muscle injected analgesia(MIA)and rectum administred analgesia (RAA).Method:One hundred and forty-four patients of gastrointestinal cancer,Who were randomly allocated to group PCA?group MIA and group RAA,were observed for 3 days after operation.Result:Analgesic efficacy of group PCA is better than that of group MIA and group RAA respectively ( P <0 01),Sleeping time within 24 hours in group PCA is longer than that of group MIA and group RAA( P <0 01).There were remarkable difference among group PCA?group MIA and group RAA in intestinal peristalsis recovery and exhaust time ( P <0 05).After operation,serum cortisol and blood sugar level of group PCA was much lower than that of group MIA and group RAA( P <0 01).But there were no significant difference in the incidence of adverse reaction among the three groups( P <0 05).Conclusion:PCA has excellent analgesia,reduce stress response and endocrine change after sugery.