临床误诊误治2025，Vol.38Issue(6)：49-54,6.DOI:10.3969/j.issn.1002-3429.2025.06.010
术中直视下肋间神经阻滞与术后针刺镇痛在胸腔镜手术后镇痛的效果比较
Comparison of Analgesic Effects of Intercostal Nerve Block under Direct Visualization During Surgery and Acupuncture Analgesia after Thoracosco-py Surgery
摘要
Abstract
Objective To compare the efficacy of intercostal nerve block(ICNB)under direct visualization during surgery with postoperative acupuncture analgesia for pain management after thoracoscopic surgery.Methods A total of 64 pa-tients with pulmonary nodules who underwent thoracoscopic procedures between July 2023 and June 2024 were enrolled and as-signed to Group A(n=32)or Group B(n=32)according to random number table method.Group A received intraoperative ICNB analgesia under direct visualization,while Group B received postoperative acupuncture analgesia.Postoperative visual analogue scale(VAS)scores,Subjective Pain Satisfaction Scores(PSS),time to first ambulation,postoperative inflammatory markers,and the incidence of related adverse events between the two groups were compared.Results At 6 and 12 h after surgery,the VAS scores for Group A were significantly lower than those for Group B(P＜0.05).At 36 and 72 h after surgery,Group A demonstrated significantly higher VAS scores than Group B at the 36 to 72 h after surgery(P＜0.05).There were no significant differences in the rates of rescue analgesia,length of hospitalization after surgery,and the occurrence of postoperative adverse events between the groups(P＞0.05).The time to first ambulation was significantly shorter in Group A[(22.38±5.67)h]compared with Group B[(30.16±6.23)h](P＜0.01).At 1 d after surgery,Group A reported higher satisfaction scores than Group B;however,at 3 and 7 d after surgery,satisfaction scores in Group A were lower than those in Group B(P＜0.05).At 3 d after surgery,the levels of C reactive protein and white blood cell counts in Group B were significantly lower than those in Group A(P＜0.05).Conclusion Both analgesic techniques provided effective pain relief following thoracoscopic surgery.In the early postoperative phase,ICNB under direct visualization yielded superior pain control compared with postoperative acupuncture analgesia.However,over time,the analgesic effect of acupuncture gradually surpassed that of ICNB.Both methods exhibited a low incidence of adverse events.关键词
肋间神经阻滞/术后针刺镇痛/胸腔镜检查/肺结节/疼痛,手术后/C反应蛋白/白细胞计数Key words
Intraoperative intercostal nerve block/Postoperative acupuncture analgesia/Thoracoscopy/Pulmonary nodules/Pain,postoperative/C reactive protein/White blood cell count分类
临床医学引用本文复制引用
王岳峰,肖瑶,姜长林,杨雪峰..术中直视下肋间神经阻滞与术后针刺镇痛在胸腔镜手术后镇痛的效果比较[J].临床误诊误治,2025,38(6):49-54,6.基金项目
大庆市指导性科技计划项目(zdy-2023-85) （zdy-2023-85）
黑龙江卫生健康委科研课题(2019364) （2019364）
