摘要
目的观察经尿道前列腺切除术(TURP)、经尿道输尿管取石术(URL)和微创经皮肾穿刺取石术(MPCNL)患者术后疼痛程度与规律.方法随机选择一期择期手术成年患者分为4组,Ⅰ组:ⅠLU组为左URL(52例),ⅠRU组右URL(57例),ⅠDU组双侧URL(15例);Ⅱ组:ⅡLP组左MPCNL(66例),ⅡRP组右MPCNL(63例);Ⅲ组TURP(59例);Ⅳ组:ⅣT组TURP(30例),ⅣP 组MPCNL(34例),两亚组均术毕静注氯诺昔康8 mg,继以术后静脉自控镇痛治疗(PCIA) (0.04%,2 ml/h).以视觉模拟评分法(VAS)测评术后24h内最大疼痛程度(Pmax)、术后第24h时点的疼痛程度(P24)和McGill疼痛问卷(MPQ)查询.结果Ⅱ组各亚组与Ⅲ组、Ⅱ组各亚组与Ⅰ组各亚组的Pmax或P24组间比较均有统计学差异(p<0.05);ⅣT的Pmax或P24均小于Ⅲ组(p<0.05),ⅣP的Pmax或P24均小于ⅡLP或ⅡRP(p<0.05),Ⅰ～Ⅲ组术后24h需应用镇痛药者分别为12例(9.7%)、27例(20.9%)和4例(7.3%),各组中应用与无应用镇痛药患者的Pmax或P24组间比较均有显著统计学差异(p<0.05),Ⅰ和Ⅲ组为会阴部'胀痛',Ⅱ组为术侧腰部'钝痛'与'胀痛'.结论 TURP和MPCNL患者术后应积极进行疼痛治疗,氯诺昔康能有效地缓解术后疼痛.
Objective To investigate the postoperative pain in patients undergoing transurethral resection of prostate （TURP）, ureteroseopic lithotomy （UBL） or minimally invasive percutaneous nephrolithotomy （MPCNL）. Methods All adult cases scheduled for procedure were randomized into four groups. Group I was performed URL： subgroup I LU was left side （n = 52）, I RU was fight side （n = 57）, and I DU was double side （n = 1 ）. Group Ⅱ was performed MPCNL： subgroup Ⅱ LP was left （n = 66） and Ⅱ RP was right （ n = 63）. Group m was performed TURP （ n = 59）. Group Ⅳ ： subgroup Ⅳ T was performed TURP （ n = 30）, Ⅳ P was performed MPCNL （n= 34）. Lomoxicam was injected when the operation ended, and used with PCIA then. The maximum of pain （Pmax） and the degree of pain in the 24th hour （P24） evaluated by Visual Analogue Scale （VAS）, McGill Pain Questionaire were tested in 24h after operation. Results Pmax or P24 was significant between each subgroup of group Ⅱ and group Ⅲ, and each subgroup of group I （p 〈 0.05 ）. The pain site was at perineum in group I or Ⅲ , at the waist of operative side in group Ⅱ Conclusion Postopeation pain should be actively reliefved after TURP or MPCNL, and Lomoxicam is effective.
出处
《现代临床医学生物工程学杂志》
2005年第4期285-287,共3页
Journal of Modern Clinical Medical Bioengineering
