ACM  >> Vol. 5 No. 4 (December 2015)

    胸外科术后疼痛的中西医研究进展
    Chinese and Western Medicine Research Progress of Thoracic Surgery Postoperative Pain

  • 全文下载: PDF(372KB) HTML   XML   PP.207-211   DOI: 10.12677/ACM.2015.54033  
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作者:  

张 琨:上海中医药大学,上海 ;
寿伟臻:上海中医药大学附属龙华医院,上海

关键词:
胸外科术后疼痛中西医Thoracic Surgery Postoperation Ache Traditional and Western Medicine

摘要:

75%~85%的术后患者将会经历不同程度的疼痛,胸外科手术所引起的疼痛被认为是最强烈疼痛之一。对于很多术后患者来说,术后疼痛可能是他们一生中所经历的最为严重的疼痛。但是对于术后的镇痛方法,医学界至今并未达成相应共识,即使有共识,程度上也存在这巨大差异。临床上术后镇痛主要以西医治疗为主,但存在明显的不足,中医通过辨证论治结合针灸治疗在减轻术后疼痛方面有较好的疗效。因此,我们需要中西医结合,发掘更为安全有效的术后多模式镇痛方法,为减轻病人术后疼痛及疼痛造成的多种并发症提供科学的治疗方案。中西医结合的多模式镇痛方法在术后创口疼痛的治疗方面有相当广阔的前景,具有效果明显,安全无副作用等优点,值得进一步深入的研究。

Seventy-five percent to eighty-five percent of patients may experience different levels of post-operative pain. In clinic, postoperative pain is scary and one of the most common pain. For some patients, postoperative pain is probably the worst pain they may experience in life. But for post-operative analgesia, the public and even the medical fraternity itself do not reach consensus, even if there is consensus, degree of difference is huge. Clinical postoperative analgesia is mainly composed of western medicine, but has obvious deficiencies. Traditional Chinese medicine which combines the syndrome differentiation with the acupuncture treatment has better efficacy in reducing postoperative pain. Therefore, we need to combine traditional Chinese and western medicine, discover a safer and more effective method of postoperative multimodal analgesia and provide scientific treatments to reduce patients postoperative pain and various complications caused by the pain. Multimodal analgesia method of combining traditional Chinese with western medicine in the treatment of postoperative wound pain has fairly broad prospects. It has the obvious effect. The advantage of this approach is safe without side effects. It is worthy of further research.

文章引用:
张琨, 寿伟臻. 胸外科术后疼痛的中西医研究进展[J]. 临床医学进展, 2015, 5(4): 207-211. http://dx.doi.org/10.12677/ACM.2015.54033

参考文献

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[27] 贾红玲, 张永臣, 单秋华. 针刺镇痛的中医理论与西医神经内分泌免疫网络调节[J]. 针灸临床杂志, 2006(9): 6-7.
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[29] 周燕艳. 术后急性疼痛治疗的新进展[J]. 临床药物治疗杂志, 2012(5): 34-38.
[30] 张志英, 高瑞臣. 外科术后疼痛特点与护理措施探讨[J]. 健康必读(中旬刊), 2013, 12(5): 409-410.
[31] 刘伟, 苏跃, 耿万明. 胸科手术后慢性疼痛研究进展[J]. 中华临床医师杂志(电子版), 2010, 4(7): 1042-1044.
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http://dx.doi.org/10.1016/j.ejcts.2006.03.031
[34] Macrae, W.A. (2008) Chronic Post-Surgical Pain: 10 Years on. British Journal of Anaesthesia, 101, 77-86.
http://dx.doi.org/10.1093/bja/aen099
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http://dx.doi.org/10.1016/j.ejcts.2009.02.005
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[37] 李燕飞. 术后病人疼痛评估及镇痛的护理进展[J]. 医学理论与实践, 2009, 22(3):276-278.
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http://dx.doi.org/10.1016/j.anclin.2008.01.007
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[46] 黄晓影. 术后镇痛麻醉方法的研究进展[J]. 中外健康文摘, 2011, 8(6): 149-150.
[47] 鲁昕, 邱贵兴. 围手术期镇痛在骨关节手术中的新进展[J]. 中国矫形外科杂志, 2009, 24: 1873-1875.
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http://dx.doi.org/10.1016/j.ejcts.2007.12.003
[50] Wucl, C.S.R., Richman, J.M., et al. (2005) Efficacy of Postoperative Patient-Controlled and Continuous Infusion Epidural Analgesia versus Intravenous Patient-Controlled Analgesia with Opioids: A Meta-Analysis. Anesthesiology, 103, 1079-1088.
http://dx.doi.org/10.1097/00000542-200511000-00023
[51] Gottschalk, A., Smith, D.S., Jobes, D.R., et al. (1998) Preemptive Epidural Analgesia and Recovery from Radical Prostatectomy: A Randomized Controlled Trial. JAMA, 279, 1076-1082.
http://dx.doi.org/10.1001/jama.279.14.1076
[52] Bong, C.L., Samuel, M., Ng, J.M., et al. (2005) Effects of Preemptive Epidural Analgesia on Post-Thoracotomy Pain. Journal of Cardiothoracic and Vascular Anes-thesia, 19, 786-793.
http://dx.doi.org/10.1053/j.jvca.2005.08.012
[53] 杨伟, 张磊昌, 周艳. 穴位刺激法在肛肠病术后镇痛的应用概述[J]. 广西中医学院学报, 2009(3): 63-64.
[54] 黄堃. 针灸止痛有科学依据[J]. 大科技(百科新说), 2010(8): 33.
[55] 贾红玲, 张永臣, 单秋华. 针刺镇痛的中医理论与西医神经内分泌免疫网络调节[J]. 针灸临床杂志, 2006(9): 6-7.
[56] 徐栋, 方剑乔. 针药复合麻醉降低手术应激反应的应用前景[J]. 针灸临床杂志, 2010, 26(4): 68-71.