摘要
目的 :比较术后用PCA与未行PCA治疗的病人术后心肌缺血发生率及其严重程度 ,观察PCA是否可有效地减少术后心肌缺血的发生。方法 :选择 6 0例择期腹部手术术后病人 ,ASAⅡ～Ⅲ级。手术结束后一组病人用PCA ,另一组病人 (对照组 )用传统的肌注镇痛。术后采用视觉模拟评分法评定镇痛效果 ,用动态心电图监测术后 2 4小时心肌缺血情况。结果 :PCA组病人镇痛效果明显优于对照组 (P <0 0 5 ) ;PCA组病人心肌缺血发生率 (2 3 3% )明显低于对照组 (5 3 3 % ) (P <0 0 5 ) ;缺血程度与对照组比较有所减轻 ,但无统计学差异 (P >0 0 5 )。结论 :术后PCA治疗可有效地降低冠心病及冠心病高危因素病人术后心肌缺血发生率 。
Objective:To compare the incidence and severity of postoperative myocardial ischemia in abdominal surgical patients with coronary artery disease or with high risk of myocardial ischemia who received PCA or conventional pain treatment.Methods:Thirty patients(PCA group) received iv PCA with fentanyl 0 02mg/h as a background infusion and a bolus dose of 0 03mg;thirty patients(control group) received pethitine 75 100mg intramuscular injection as the patient needed.The intensity of pain was assessed after extubation and 24h after surgery using a visual analogue scale(VAS).The myocardial ischemia was detected by Holter monitor,which initiated immediately after surgery and lasted for 24 hours.Results:VAS pain score was 2 51±0 52 in PCA group and 4 12±1 34 in controlled group at 24h after surgery( P< 0 05).Incidence of postoperative myocardial ischemia was 23 3% in PCA group and 53 3% in controlled group( P< 0 05).However there is no significant difference in the change of ST segments between the two groups( P> 0 05).Conclusion:PCA therapy can effectively reduce the incidence of postoperative myocardial ischemia in the cardiac patients undergoing noncardiac surgery.
出处
《临床麻醉学杂志》
CAS
CSCD
2000年第8期395-397,共3页
Journal of Clinical Anesthesiology
