摘要：目的：比较硬膜外自控镇痛与静脉自控镇痛在食管癌术后的镇痛效果。方法：70例食管癌患者随机分为两组：硬膜外自控组(布比卡因加芬太尼)和静脉自控组(吗啡加氟哌啶)。分别比较两组视觉模拟评分(VAS)、镇静程度评分、呼吸频率、脉搏血氧饱和度(SpO2)、术后副反应以及患者满意度等指标。结果：静脉自控组患者VAS评分和镇静程度评分显著高于硬膜外自控组(P<0.05)；呼吸频率和SpO2在两组间没有显著性差异(P>0.05)。静脉自控组恶心呕吐的发生率显著高于硬膜外自控组(P<0.05)；硬膜外自控镇痛的满意度为91.3%高于静脉自控镇痛的满意度(80.0%)(P<0.05)。结论：自控镇痛在患者中的满意度较高，硬膜外自控镇痛的效果好于静脉自控镇痛的效果。

    关键词: 术后镇痛；患者自控；食管癌

    Clinic Observing the Effect of Postoperative Analgesia of Esophageal Carcinoma by Using PCA

    QIU Shu-bin，HUANG Xuan-diao

    (Department of Anesthesiology, Second Affiliated Hospital to Shantou University Medical College, Guangdong Shantou 515000, China)

    Abstract: Objective: To compare the effect of epidural PCA with venous PCA on postoperative analgesia of esophageal carcinoma. Method: 70 cases were randomly divided into two group: epidural PCA(pupivocaine and fentanyl) and venous PCA(morphine and droperidol).Visual analogue scale(VAS), sedation scale, respiratory rate,pulse, SpO2 ,side-effect of operation and satisfactory degree of patients were compared between two groups. Result: VAS and sedation scale in group using venous PCA were significantly higher than in group using epidural PCA(P<0.05). there were no significant difference in respiratory rate and SpO2 between two groups(P>0.05). Incident rates of nausea and spew in group using venous PCA were significantly higher than in group using epidural PCA(P<0.05). Satisfactory degree of epidural PCA(91.3) were significantly higher than venous PCA(80.0%)(P<0.05).Conclusion: There was a higher satisfactory degree in the patients who used PCA, furthermore, effect of epidural PCA was better than venous PCA. ......