目的：探讨不同麻醉方法对脑卒中患者术后镇痛效果的影响。方法选择2012‐03—2013‐06收治的的114例脑卒中患者，根据所采用麻醉方法的不同随机分为A、B、C3组，A组采用全身静脉麻醉的麻醉方法，B组采用全身静脉＋吸入复合麻醉的麻醉方法，C组采用硬膜外复合静脉麻醉的麻醉方法，比较3种不同麻醉方法的视觉模拟评分（VAS）、镇痛效果及并发症情况。结果3组治疗前VAS评分比较差异无统计学意义（P＞0.05），3组治疗6 d、12 d、24 d、48 d后的VAS评分差异有统计学意义（ P＜0.05）；A组、B组及C组3组镇痛效果有效率分别为68.4％、78.9％、92.1％，C组的镇痛效果有效率显著高于其他2组，3组比较差异有统计学意义（ P＜0.05）；A 组、B组及C组3组患者常见并发症（低血压、恶性呕吐、嗜睡、呼吸抑制、死亡及头晕）的发病率分别为34.2％、15.8％、7.90％，C组并发症的发病率显著低于其他2组，3组比较差异有统计学意义（ P＜0.05）。结论采用硬膜外复合静脉麻醉较全身静脉麻醉对脑卒中的镇痛效果有显著提高，对患者治疗后的VAS评分有显著改善，且可有效降低并发症发病率，值得进一步研究。%Objective To investigate the effects of different anesthesia methods on postoperative analgesia in patients with stroke.Methods 114 patients with stroke from March 2012 to June 2013 were chosen for the study and divided into group A , group B and group C according to different anesthesia methods. Group A received general intravenous anesthesia ;group B a‐dopted inhalation combined anesthesia + intravenous anesthesia ;group C used epidural combination anesthesia. Visual analog scale(VAS) ,analgesia effects and complications were assessed in different groups.Results VAS scores showed no significant difference in three groups before treatment (P>0.05) ,but after 6‐,12‐,24‐and 48‐day treatment the VAS scores had statis‐tical difference among three groups (P<0.05);the analgesia rate of group A ,group B and group C was 68.4% ,78.9% and 92.1% ,group C indicated significant difference compared with group A and group B (P<0.05). In addition ,the complication rate of group A ,group B and group C was 34.2% ,15.8% ,7.90% ;group C showed lower rate than the other two groups (P<0.05);complications mainly included hypotension ,malignant vomiting ,drowsiness ,respiratory depression ,death ,and diz‐ziness.Conclusion In summary ,compared with general intravenous anesthesia ,epidural anesthesia has remarkable effect on analgesia in stroke patients ,which can improve the VAS scores and reduce the complication rate. It’s worthy of being widely applied.
展开▼
