摘要
目的探讨妇科良性疾病腹腔镜手术后中重度疼痛发生情况及影响因素。方法前瞻性选取2021年4月至2021年7月北京大学人民医院114例因妇科良性疾病行腹腔镜下子宫、附件切除术患者作为研究对象,其中100例患者符合标准纳入分析。按照术后疼痛程度分为中重度疼痛组(63例),轻度疼痛组(37例);并按手术涉及脏器数分为三组:单脏器手术(45例)、双脏器手术(30例)、3个及以上脏器手术(25例)。进行术后问卷调查,比较术后72 h轻度疼痛与中重度疼痛组患者身高、体质量、体质指数(BMI)、术前疼痛、手术类型、手术时间、麻醉镇痛用药及疼痛对患者活动及睡眠影响。采用单因素和logistic多因素回归分析术后疼痛的危险因素。结果多脏器手术术后疼痛发生率(80.00%,20/25)高于单脏器手术(51.11%,23/45)及双脏器手术(66.67%,20/30),三组比较,差异有统计学意义(P<0.05);而三组术前疼痛状态、BMI分级、手术时间比较差异无统计学意义(P>0.05)。logistic多因素回归分析显示,多脏器手术(OR=7.541,95%CI:2.035~27.952,P=0.0025)、镇痛药用量(OR=1.097,95%CI:1.009~1.193,P=0.0303)是术后疼痛的危险因素(P<0.05)。并且术后调查问卷显示,疼痛显著影响患者的活动及睡眠(P<0.05)。结论妇科腹腔镜手术多脏器术后疼痛发生率高,疼痛显著影响患者术后活动与睡眠,应根据不同手术类型进行疼痛管理。
Objective To investigate the occurrence and influencing factors of moderate and severe pain after laparoscopic surgery for benign gynecological lesions.Methods A total of 114 gynecological patients undergoing laparoscopic hysterectomy and adnexectomy in Peking University People’s Hospital from April 2021 to July 2021 were prospectively selected as the study subjects,and 100 patients with benign gynecological diseases were included in the analysis.According to the degree of postoperative pain,they were divided into moderate and severe pain group(63 cases)and mild pain group(37 cases).According to the number of organs involved in the operation,the patients were divided into three groups:single organ operation(45 cases),double organ operation(30 cases),three or more organs operation(25 cases).Height,body mass,body mass index(BMI),preoperative pain degree,operation type,operation time and analgesic drug dosage were compared between mild pain group and moderate and severe pain group 72 h after operation.Univariate and logistic multifactor regression were used to analyze the risk factors of postoperative pain.Results The incidence of postoperative pain in multiple organ surgery(80.00%,20/25)was higher than that in single organ surgery(51.11%,23/45)and double organ surgery(66.67%,20/30),and the difference was statistically significant(P<0.05).Logistic multivariate regression analysis showed that multiple organ surgery(OR=7.541,95%CI:2.035-27.952,P=0.0025)and analgesic drug dosage(OR=1.097,95%CI:1.009-1.193,P=0.0303)were risk factors for postoperative pain(P<0.05).Postoperative pain significantly affected the activity and sleep of patients(P<0.05).Conclusion The incidence of postoperative pain in gynecological laparoscopic multi-organ surgery is high,and the pain significantly affects postoperative activity and sleep of patients.Pain management should be carried out according to different surgical types.
作者
张秦
杜爽
冯艺
ZHANG Qin;DU Shuang;FENG Yi(Department of Anesthesiology,Peking University People's Hospital,Beijing 100044,China)
出处
《中国妇产科临床杂志》
CSCD
2022年第2期150-153,共4页
Chinese Journal of Clinical Obstetrics and Gynecology
关键词
腹腔镜
妇科手术
良性疾病
术后疼痛
laparoscopy
gynecological surgery
benign disease
postoperative pain
