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題名 | 硬脊膜外止痛作用對胃穿孔病人的術後影響 |
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作者 | 許汝寧; | 書刊名 | 中華民國外科醫學會雜誌 |
卷期 | 16:2 1983.06[民72.06] |
頁次 | 頁176-181 |
分類號 | 416.5 |
關鍵詞 | 胃穿孔病人; 硬脊膜外止痛; |
語文 | 中文(Chinese) |
中文摘要 | 胃穿孔是腹部手術中發生肺部併發症最多的一種手術。為了減少手術後的併發症及促進恢復。我們應用硬脊膜外止痛法來作術後止痛。同時和傳統的止痛法作一比較。我們有50個病例,在手術後第一天之早、午、晚各打入10 c. c.之0.25% Bupivacaine於預留之硬脊膜外導管。第二天之早、晚各一次。第三天則早上打一次。另外一組50個病例則用地美露(Demerol) 50 mg。每4小時肌肉注射。結果我們發現硬脊膜外止痛法會增加潮氧量,分呼吸量。在血氣分析方面,氧分壓及氧飽和度都比對照組高,二氧化碳的分壓則比較低。病人的體温變化比較少,排氧時間提前,同時住院時間也縮短。我們認為硬脊膜外止痛法對胃穿孔病人是比較理想的方法。 |
英文摘要 | Abdominal surgery has been found to be associated with a high rate of postoperative pulmonary complicatioris. Perforated peptic ulcer is the highest among them. In order to minimize the postoperative complications and enhance the recovery, epidural analgesia was used for postoperative pain relief in comparison with conventional method. Fifty patients having perforated peptic ulcer were given 10 ml of 0.25% Bupiavacaine injected epidurally three times on the first post-operative day, twice on the second day and once on the third day. The control group consisted of another set of 50 patients who were given pathidine (Demerol) intramuscularly for pain relief. The study including the following items: tidal volume, minute volume, blood gases analysis, the time required for flatus passage, body temperature change during the first 48 hours, the time of initial oral intake and length of hospital stay. The patients given epidural analgesia showed an increase in tidal volume andminute volume as compared with the control gorup. The epidural analgesia patients also showed an increase in PO2 and O2 saturation with reduction in PCO2 on blood gases analysis, and required less time to pass flatus. They additionally had less body temperature elevation during the first 48 hours after the operation and had a shorter hospital stay. Epidural analgesia has been shown to be a more effective method of pain relief for perforated peptic ulcer patients. |
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