創傷性氣胸患者應用PCA泵鎮痛聯合胸腔閉式引流手術治療的效果及對患者呼吸道健康的影響

袁錦權 蘇亞海 張益

【摘要】 目的：探討創傷性氣胸患者應用患者自控鎮痛（patient controlled analgesia，PCA）泵鎮痛聯合胸腔閉式引流手術治療的效果及對患者呼吸道健康的影響。方法：回顧性分析2017年3月-2018年4月本院收治的創傷性氣胸患者82例的臨床資料，依據治療方式將患者分為對照組和試驗組，各41例。對照組予以胸腔閉式引流術治療，試驗組予以PCA泵鎮痛聯合胸腔閉式引流術治療，對比兩組患者的治療效果及呼吸道健康改善情況。結果：治療后，試驗組血清C反應蛋白、疼痛評分均較對照組低，差異均有統計學意義（P<0.05）;試驗組并發癥發生率為4.88%，較對照組的19.51%低，差異有統計學意義（P<0.05）;治療后，試驗組動脈血氧分壓（PaO2）、二氧化碳分壓（PaCO2）均優于對照組，差異均有統計學意義（P<0.05）;試驗組肺復張時間、拔管時間、住院時間均較對照組短，差異均有統計學意義（P<0.05）。結論：PCA泵鎮痛聯合胸腔閉式引流手術治療創傷性氣胸可有效減輕患者創傷應激反應與疼痛，減少并發癥，并促進患者呼吸功能恢復，進而使患者康復時間縮短，值得臨床應用。

【關鍵詞】 創傷性氣胸; PCA泵鎮痛; 胸腔閉式引流手術; 呼吸道健康

【Abstract】 Objective：To investigate the effect of patient controlled analgesia（PCA）pump analgesia combined with thoracic closed drainage in patients with traumatic pneumothorax and its effect on respiratory health.Method：The clinical data of 82 patients with traumatic pneumothorax admitted to our hospital from March 2017 to April 2018 were retrospectively analyzed，they were divided into control group and experimental group according to different treatment methods，41 cases in each group.The control group was treated with closed thoracic drainage，while the experimental group was treated with PCA pump analgesia combined with closed thoracic drainage.The therapeutic effect and respiratory health improvement of the two groups were compared.Result：After treatment，the serum C-reactive protein and pain score of the experimental group were lower than those in the control group，the differences were statistically significant（P<0.05）.The complication rate of the experimental group was 4.88%，which was lower than 19.51% in the control group，the difference was statistically significant（P<0.05）.After treatment，the arterial oxygen partial pressure（PaO2）and pulsed carbon dioxide partial pressure（PaCO2）in the experimental group were better than those in the control group，the differences were statistically significant（P<0.05）.The lung recruitment time，extubation time and hospitalization time of the experimental group were shorter than those in the control group，the differences were statistically significant（P<0.05）.Conclusion：PCA pump analgesia combined with thoracic closed drainage for the treatment of traumatic pneumothorax can effectively reduce the patients traumatic stress response and pain，reduce complications，and promote the recovery of patients respiratory function，thus shortening the recovery time of patients，which is worthy of clinical application.

【Key words】 Traumatic pneumothorax; PCA pump analgesia; Thoracic closed drainage; Respiratory health