吸烟者胸部手术后自控静脉镇痛效果观察-论文.pdf

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1、山东医药2014年第54卷第31期吸烟者胸部手术后白控静脉镇痛效果观察蔡兴志，于爱兰，张宗旺，刘冬华，张平(聊城市人民医院，山东聊城252000)摘要：目的观察吸烟者胸部手术后的自控静脉镇痛(PCIA)效果。方法采用回顾性分析方法，将152例实施PCIA的男性胸部手术患者分为非吸烟组(NS组)70例和吸烟组(S组)82例，比较两组术中芬太尼用量、手术时间及术后24、48h的舒芬太尼用量；术后0～48h采用数字评价量表(NRS)评估静息与咳嗽时的疼痛评分；观察有无镇痛相关不良反应。结果两组术中芬太尼用量、手术时间均无显著差异(P均>0．05)；S组术后

2、24、48h舒芬太尼累积用量及每千克体质量用量均明显大于NS组，术后0—48h静息与咳嗽时NRS评分均高于NS组(P均<0．05)；两组术后恶心、呕吐、过度镇静、呼吸抑制发生率无显著差异(P均>0．05)。结论与不吸烟者比较，吸烟者胸部手术后疼痛程度增强、PCIA所用药物剂量增大，但PCIA相关不良反应无明显变化。关键词：吸烟；胸外科手术；肺叶切除术；食管癌根治术；纵隔肿瘤切除术；自控静脉镇痛；舒芬太尼doi：10．3969／j．issn．1002—266X．2014．31．019中图分类号：R614．2文献标志码：B文章编号：1002-266X(2

3、014)31-0052-03Eficacyofpostoperativepatient-controlledintravenousanalgesiainsmokingpatientsundergoingthoracicsurgeryCAIXing—zhi，YUAi—lan，ZHANGZong—wang，LIUDong—hua，ZHANGP讯g(LiaochengPeople3Hospital，Liaocheng252000，China)Abstract：ObjectiveToinvestigatetheeffectofpostoperativepat

4、ient—controlledintravenousanalgesia(PCIA)insmokingpatientsundergoingthoracicsurgery．MethodsTheretrospectiveanalysismethodwasused．Totally152malepa—tientsundergoingthoracicsurgeryandreceivedpostoperativePCIAweredividedintothenon—smokinggroup(groupNS，n：70)andsmokinggroup(groupS，n=

5、82)．Thedosageofsufentanilduringsurgery，operationtime，cumulativeamountofself-administeredsufentanilat24and48haftersurgerywerecomp~edbetweenthetwogroups．Thenumericalratingscale(NRS)wasusedtoassessthetranquillizationandcoughingpainintensityduring0-48haftersurgery．Analgesiare—lated

6、adversereactionswereobserved．ResultsTherewerenosignificantdifferencesinthedosageofsufentanilduringsurgeryandoperationtimebetweengroupsNSandN(allP>0．05)．Thecumulativeamountanddosageperbodyweightofsufentanilat24and48hinthegroupSweresignificantlyhigherthanthatinthegroupNS，andtheNR

7、Sscoresattran—quillizationandcoughing(0-48haftersurgery)weresignificantlyhigherinthegroupSthanthoseofthegroupNS(allP<0．05)．Nosignificantdifferenceswerefoundinthepostoperativecomplicationssuchasnauseaandvomiting，sedation，andtheincidenceofrespiratorydepressionbetweenthetwogroups(

8、allP>0．05)．ConclusionComp~edwithnon—smokers，smokershav