目的 观察各年龄组患者脊椎融合术后使用患者自控静脉镇痛(patient-controlled intravenous analgesia,PCIA)进行镇痛治疗的有效性及并发症发生的情况,并评价镇痛效果与年龄、性别等因素的关系.方法 选取自2007年6月至2009年2月于我院行脊椎融合手术的患者154名,根据年龄分为20岁以下组、20岁~39岁组、40岁~59岁组和60岁及以上组,各组再根据性别分为2个亚组.记录患者术后的痛觉评分、与PCIA应用有关的并发症以及患者对PCIA治疗的满意度. 结果各组患者使用PCIA治疗后VAS评分均降低.PCIA使用时间与年龄、性别无明显关联.40岁~59岁年龄组中患者VAS评分与年龄存在正相关.女性患者组中VAS评分与年龄存在正相关.87.7%的患者对术后PCIA治疗的满意度为优和良.结论 PCIA治疗腰椎融合术术后疼痛是安全、有效的.
Objective To observe the efficacy of patient-controlled intravenous analgesia (PCIA) and associated complications following spinal fusion surgery in different age patients, and to evaluate the relationship of PCIA effects with age and gender. Methods One hundred and fifty four patients undergoing spinal fusion surgery in Leshan People's Hospital from June of 2007 to February of 2009 were included in this study. According to the patients' age, they were divided into four groups: <20 years, 20-39 years, 40-59 years and ≥60 years. Each group was further divided two subgroups, according to gender. The visual analogue scale (VAS) of postoperative pain and complications related to use of PCIA and patients's satisfaction with the PCIA were recorded. Results VAS in the four groups significanly decreased after treatment of PCIA. The duration of PCIA treatment was not related to patients' age and genders. There were positive correlations between VAS and age in the female subgroup and in the 40-59 group. 87.7% of all had an excellent or good satisfaction to the PCIA treatment. Conclusion Use of PCIA for postoperative analgesia in patients undergoing the spinal fusion surgery is safe and efficacious.