摘要:
Objective To investigate the application value of intercostal nerve cryotherapy on incisional pain after thoracotomy.Methods Seventy-six patients underwent open thoracotomy from October 2014 to July 2016 were randomly divided into two groups, with 38 patients in each group.The control group received intravenous controlled analgesia, the study group received intercostal nerve cryotherapy.The different postoperative time of two groups of pain (VAS) before and after surgery, serum inflammatory factor [interleukin-6 (IL-6), C reactive protein (CRP)] the relevant indicators and stress response (angiotensin, cortisol and beta endorphin), pulmonary function (peak expiratory flow rate PEF 1 s), forced expiratory volume (FEV1), forced vital capacity (EVC) level changes were made statistical comparison.And the incidence of adverse reactions in the two groups was statistically analyzed.Results ① The degree of pain: VAS scores at immediately after surgery, 1 h, 4 h, 8 h, 12 h in study group were lower than those in the control group, the differences were significant (P0.05), the index levels 1 d after operation in study group were lower than those in the control group, the differences were significant (P0.05), the index levels in study group 1 d after operation were lower than that in the control group, the differences were significant (P0.05), every index in research group 1 d after operation was higher than that in the control group, but the differences were not significant (P>0.05), FEV1, EVC, PEF in the study group in study group 3 days after operation were significantly higher than those in control group, the differences were significant (P0.05),术后1 d研究组各指标水平低于对照组,差异有统计学意义(P0.05),术后1 d研究组各指标水平低于对照组,差异有统计学意义(P0.05),术后1 d研究组各指标水平高于对照组,但差异未见统计学意义(P>0.05),术后3 d研究组PEF、FEV1、EVC水平明显高于对照组,差异有统计学意义(P<0.05);⑤不良反应:研究组不良反应发生率(13.15%)低于对照组(36.83%),差异有统计学意义(P<0.05).结论 肋间神经冷冻可缓解开胸术后疼痛感,减轻机体炎性反应与应激反应程度,改善患者肺功能,且安全性较高.