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目的 探讨病人硬膜外自控镇痛 (patientcontrolledepiduralanalgesia ,PCEA)在子宫动脉栓塞术 (uter inearterialembolization ,UAE)治疗子宫腺肌病中的应用。方法 选择 75例行UAE治疗子宫腺肌病的患者 ,随机分成 3组 ,Ⅰ、Ⅱ组术前开始予自控镇痛 2 4小时 ,予相同的镇痛模式 ,两种不同的药物配伍 :罗哌卡因配伍吗啡为Ⅰ组 (n =30 ) ,罗哌卡因、吗啡配伍氟哌啶为Ⅱ组 (n =30 ) ,Ⅲ组术后自觉疼痛时予传统的肌注四氢巴马汀(颅痛定 )或盐酸哌替啶 (n =15 ) ,比较三组术中和术后 2 4小时内的镇痛效果、不良反应及安全性。结果 PCEAⅠ组、Ⅱ组的镇痛效果明显优于Ⅲ组 ,结合不良反应其临床疗效为 :Ⅱ组 >Ⅰ组 >Ⅲ组。结论 UAE治疗子宫腺肌病术中应用PCEA镇痛效果好 ,不良反应小 ,舒适、安全。
Objective To investigate the application of patient-controlled epidural analgesia (PCEA) in the treatment of adenomyosis with uterine arterial embolization (UAE). Methods Seventy-five patients undergoing UAE for treatment of adenomyosis were randomly divided into three groups. Patients in groups Ⅰ and Ⅱ were given controlled analgesia for 24 hours before operation. The same mode of analgesia was given. Two different kinds of drugs were prescribed: ropivacaine The combination of caffeine and morphine in group Ⅰ (n = 30), ropivacaine and morphine combined with droperidol in group Ⅱ (n = 30), group Ⅲ received conventional intramuscular injection of tetrahydropalmatine (N = 15). The analgesic effects, side effects and safety of the three groups were compared within 24 hours after operation and 24 hours after operation. Results The analgesic effects of PCEAⅠ and Ⅱ groups were significantly better than those of Ⅲ group. Combined with adverse reactions, the clinical curative effects were as follows: group Ⅱ> group Ⅰ> group Ⅲ. Conclusion UAE treatment of adenomyosis PCEA analgesic effect is good, small adverse reactions, comfort and safety.