袁錦權(quán) 蘇亞海 張益

【摘要】 目的：探討創(chuàng)傷性氣胸患者應(yīng)用患者自控鎮(zhèn)痛（patient controlled analgesia，PCA）泵鎮(zhèn)痛聯(lián)合胸腔閉式引流手術(shù)治療的效果及對(duì)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(chuàng)傷性氣胸患者82例的臨床資料，依據(jù)治療方式將患者分為對(duì)照組和試驗(yàn)組，各41例。對(duì)照組予以胸腔閉式引流術(shù)治療，試驗(yàn)組予以PCA泵鎮(zhèn)痛聯(lián)合胸腔閉式引流術(shù)治療，對(duì)比兩組患者的治療效果及呼吸道健康改善情況。結(jié)果：治療后，試驗(yàn)組血清C反應(yīng)蛋白、疼痛評(píng)分均較對(duì)照組低，差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）;試驗(yàn)組并發(fā)癥發(fā)生率為4.88%，較對(duì)照組的19.51%低，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）;治療后，試驗(yàn)組動(dòng)脈血氧分壓（PaO2）、二氧化碳分壓（PaCO2）均優(yōu)于對(duì)照組，差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）;試驗(yàn)組肺復(fù)張時(shí)間、拔管時(shí)間、住院時(shí)間均較對(duì)照組短，差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論：PCA泵鎮(zhèn)痛聯(lián)合胸腔閉式引流手術(shù)治療創(chuàng)傷性氣胸可有效減輕患者創(chuàng)傷應(yīng)激反應(yīng)與疼痛，減少并發(fā)癥，并促進(jìn)患者呼吸功能恢復(fù)，進(jìn)而使患者康復(fù)時(shí)間縮短，值得臨床應(yīng)用。

【關(guān)鍵詞】 創(chuàng)傷性氣胸; PCA泵鎮(zhèn)痛; 胸腔閉式引流手術(shù); 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