人工气胸联合肋间神经阻滞用于减轻近胸膜肺肿瘤微波消融术疼痛的疗效分析

发布时间：2018-04-15 09:18

本文选题：人工气胸 + 肋间神经阻滞　；参考：《介入放射学杂志》2017年03期

【摘要】：目的探讨人工气胸联合肋间神经阻滞用于减轻近胸膜肺肿瘤微波消融(MWA)术中及术后疼痛的疗效。方法将30例近胸膜肺肿瘤患者分为3组,每组10例,A组MWA前先实施人工气胸联合肋间神经阻滞,B组MWA前单纯实施人工气胸,C组MWA前单纯行肋间神经阻滞。用疼痛视觉模拟评分(VAS)评定各组患者术中及术后0、6、12和24 h的疼痛程度,记录患者术后不良反应出现情况。结果 3组患者术中VAS评分无明显差异(P=0.885);C组患者在术后6、12和24 h的VAS评分均明显增高(P=0.014,0.006,0.006)。A组和B组患者实施人工气胸后均未出现胸闷症状;A组和B组中共6例患者术后仍有少量无症状残余气胸,约1周后残余气胸自行吸收消失,1例患者术后抽气后仍存在较大范围气胸,经行胸腔闭式引流3 d后痊愈。无其它严重人工气胸相关并发症。结论人工气胸联合肋间神经阻滞能够有效减轻近胸膜肺肿瘤患者MWA术中及术后疼痛,安全性高。
[Abstract]:Objective to investigate the effect of artificial pneumothorax combined with intercostal nerve block on relieving pain during and after microwave ablation of proximal pleural lung tumors.Methods Thirty patients with near pleural lung tumor were divided into 3 groups. 10 patients in group A were treated with artificial pneumothorax combined with intercostal nerve block before MWA. Before MWA, group C received intercostal nerve block only before MWA.Visual analogue score of pain (VAS) was used to assess the degree of pain during operation and 6 hours and 24 hours after operation, and to record the occurrence of adverse reactions after operation.Results there was no significant difference in intraoperative VAS score among the three groups. The VAS scores in group C were significantly higher than those in group C at 6h and 24 h after operation. The VAS scores in group A and group B were significantly higher than those in group A and group B. There were 6 patients in group A and group B who had no symptoms of chest tightness after artificial pneumothorax.There was still a small amount of asymptomatic residual pneumothorax after operation.After about one week the absorption of residual pneumothorax disappeared. One patient still had a large range of pneumothorax after exhalation and was cured after 3 days of closed thoracic drainage.There were no other severe complications associated with artificial pneumothorax.Conclusion artificial pneumothorax combined with intercostal nerve block can effectively relieve pain during and after MWA in patients with near pleural lung tumor.
【作者单位】：济南军区总医院;解放军第401医院肿瘤科;解放军第401医院麻醉科;
【分类号】：R734

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