Objective To explore the application value and advantages of modified intercostal nerve freezing technique on postoperative recovery of traditional thoracotomy. Methods 100 patients undergoing conventional thoracotomy incision patients were randomly divided into 2 groups, group A as the modified intercostal nerve freezing group (n = 50) using the Beijing K001AND company JT-Ⅰ treatment only in the off-type freezer chest incision locating on intercostal and upper and lower intercostal space and the indwelling chest tube where the intercostal nerves were frozen;group B, continuous epidural analgesia group (n=50), using the Japanese company's electronic pump wells, plus droperidol with morphine-line continuous epidural analgesia (Patient control epidural analgesia, PCEA). All patients in two groups were using a visual analogue scale (Visual analogue scale, VAS) assessment of postoperative pain,observing patients 2 hours, 4 hours, 12 hours, 24 hours and 48 hours after surgery when the VAS score, nausea,vomiting, respiratory depression, itching, the incidence of intestinal paralysis. Results The post-operative pain of group A was better than that of group B, and the incidence rate of side effect was also lower than that of group B.Conclusions It suggested that the modified intercostal nerve freezing technique could effectively promote postoperative recovery after thoracotomy.%目的 探讨改良肋间神经冷冻技术在促进传统开胸手术后恢复中的应用价值及优势.方法 将100例择期传统切口开胸的病人随机分为A组和B组;A组为改良肋间神经冷冻组(n=50),使用北京K001AND公司JT-Ⅰ型冷冻治疗仪在关胸前对切口所在肋间及上、下各一个肋间和留置胸腔引流管所在肋间的肋间神经进行冷冻;B组为连续硬膜外自控镇痛组(n=50),采用日本wells公司的电子泵,用吗啡加氟哌利多行连续硬膜外自控镇痛(patient control epidural analgesia,PCEA).二组病人均采用视觉模拟评分法(visual analogue scale,VAS)评定术后疼痛程度,观察二组病人手术后2h、4h、12h、24 h、48h时的VAS的评分,恶心、呕吐、呼吸抑制,搔痒、肠麻痹等发生率.结果 A组手术后止痛效果好于B组,手术后镇痛副反应[如恶心(10.3%vs 23.3%)、呕吐(10.0%vs 26.7%)、头晕(6.7%vs 20.0%)等]发生率也低于B组.结论 改良肋间神经冷冻技术能有效促进传统开胸手术后恢复.
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