创伤性气胸患者应用PCA泵镇痛联合胸腔闭式引流手术治疗的效果及对患者呼吸道健康的影响

袁锦权 苏亚海 张益

【摘要】 目的：探討创伤性气胸患者应用患者自控镇痛（patient controlled analgesia，PCA）泵镇痛联合胸腔闭式引流手术治疗的效果及对患者呼吸道健康的影响。方法：回顾性分析2017年3月-2018年4月本院收治的创伤性气胸患者82例的临床资料，依据治疗方式将患者分为对照组和试验组，各41例。对照组予以胸腔闭式引流术治疗，试验组予以PCA泵镇痛联合胸腔闭式引流术治疗，对比两组患者的治疗效果及呼吸道健康改善情况。结果：治疗后，试验组血清C反应蛋白、疼痛评分均较对照组低，差异均有统计学意义（P<0.05）;试验组并发症发生率为4.88%，较对照组的19.51%低，差异有统计学意义（P<0.05）;治疗后，试验组动脉血氧分压（PaO2）、二氧化碳分压（PaCO2）均优于对照组，差异均有统计学意义（P<0.05）;试验组肺复张时间、拔管时间、住院时间均较对照组短，差异均有统计学意义（P<0.05）。结论：PCA泵镇痛联合胸腔闭式引流手术治疗创伤性气胸可有效减轻患者创伤应激反应与疼痛，减少并发症，并促进患者呼吸功能恢复，进而使患者康复时间缩短，值得临床应用。

【关键词】 创伤性气胸; PCA泵镇痛; 胸腔闭式引流手术; 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