腹部术后自控静脉镇痛的应用与对胃肠功能的影响

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1、48例，尚可9例，无效3例；而对照组的满意度则分别为优33例，尚可21例，无效6例，两组比较有显著差异(P<0．05)。PCIA组发生不良反应者9例次，对照组发生不良反应者26例次，两组不良反应发生率以对照组高(P<0．05)。PCIA组肠鸣音恢复时间、恢复排气和排便的时间明显快于对照组(P0．05)。结论：1、PCIA在腹部手术术后的镇痛效果明显优于肌肉注射镇痛，2、PCIA术后镇痛可以促进胃肠功能的早期恢复，但对60岁以上患者无明显影

2、响。关键词：腹部手术自控静脉镇痛胃肠功能2TheApplicationofPatientControlledIntravenousAnalgesiaandtheInfluenceonGastrointestinalFunctionafterAbdominalOperationMasterdegreecandidate：GaoJunSupervisor：ProfessorZhangXuefengMajor：generalsurgeryAbstractObjective：Toexplorationt

3、heeffectofgastricintestinalfunctionrecoverybypatientcontrolledintravenousanalgesiaafterabdominaloperation．Method：120patientswithabdominaloperationinourhospitalduringApril2007一Janury2008wereselected．Inthesecases，78casesweremaleand42caseswerefemale．，Th

4、eywereI8-8Iyearsold，withanaverageof49．74-5．6yearsoldandaverageweightof53．2±6．5kg．Amongthemtherewere30caseswereabove60years，withanaverageage70．3±4．8andaverageweightof58．6士12．1kg．Allthepatientswererandomlydividedintotwogroups：theexperimentalgroupadopte

5、dpatientcontrolledintravenousanalgesia(PCIA)(60CaSeS)，thecontrolgroupadoptedmuscleinjectionof’analgesicatcertaininterval．Thevarietyofoperationconsistedofepigastriumoperationandhypogastriezoneoperation．Amongthem，therewere34casesofoperationinstomachint

6、estine，4casesofoperationinpancreasandduodenum，16casesofoperationinsmallintestine，4casesofoperationinliver，28casesofoperationinbiliarytractand8casesofoperationinspleen．Therewere12casesofoperationincolon，14casesofoperationinrectumofhypogastriczoneandpe

7、lviccavity．Anesthesiamethod：Allthepatientswereinjectedagrypnal0．1g．atorpinO．5mgbeforetheoperation，whohadnothehistoryoflong—termapplicationanalgesics．AIlofthemappliedtotrachealintubationandveincombinedanesthesia．practicaldrugsofanesthesiainductionwere

8、consistedofFentanyl5弘g／kg，vecuroniumbromide0．1mg／kg，midazolamO．1g／kg，andpropofol2mg／kg．Thefullmaskoxygenandairchaneweregivenforendotraeheal3intubation，thentheOHMEDA210anesthesiamachinecontroledtherespiratory，andanesthesiamaintainedbygivingdiscontinuo