超前镇痛理念用于腹腔镜胆囊切除术后镇痛的效果观察

Observation of analgesic effect of advanced analgesic concept after laparoscopic cholecystectomy

目的观察超前镇痛理念用于腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)术后镇痛的效果。方法采用随机对照研究方法选取2022年1-10月在内蒙古医科大学附属医院肝胆外科行LC患者80例为研究对象。随机分为观察组(40例,行超前镇痛理念)和对照组(40例,行术后常规镇痛)。采用疼痛数字评分(numerical rating scale,NRS)、睡眠质量评估(匹兹堡睡眠质量指数量表PSQI)、自控镇痛泵按压次数、护理质量满意度及术后住院时长进行对比分析。结果观察组术后即刻、术后4 h、12 h、24 h的疼痛评分[(6.21±0.74)分、(4.62±0.61)分、(3.28±0.75)分、(2.18±0.47)分]明显低于对照组,其差异均具有统计学意义(P<0.05)。观察组护理满意度总分[(13.70±0.85)分]高于对照组[(12.02±1.32)分],其差异具有统计学意义(P<0.01)。观察组术后12 h、24 h、48 h睡眠质量评分[(4.55±1.23)分、(4.72±0.56)分、(2.45±0.87)分]均高于对照组,差异均具有统计学意义(P<0.01)。观察组术后8 h、12 h、24 h PCA按压次数频率[(0.37±0.49)次、(0.40±0.49)次、(0.50±0.50)次]均少于对照组,差异均具有统计学意义(P<0.01)。观察组住院时长<3 d的人数[29(72.5%)]高于对照组[11(27.5%)],而住院时长>3 d的人数低于对照组,差异有统计学意义(P<0.05)。结论超前镇痛理念应用于LC术后患者,对降低术后疼痛感、改善术后睡眠质量、减少PCA按压次数、提升护理满意度、缩短住院时长效果显著,具有临床应用价值。

Objective To observe the efficacy of advanced analgesia concepts on postoperative analgesia in laparoscopic cholecystectomy(LC).Methods A total of 80 LC patients in the department of hepatobiliary surgery of Affiliated Hospital of Inner Mongolia Medical University from January to October 2022 was selected as the study objects by the randomized controlled study method,and were randomly divided into the observation group(40 cases,advanced analgesia was performed)and the control group(40 cases,routine postoperative analgesia was performed).Numerical pain scale(NRS),sleep quality assessment(Pittsburgh sleep quality index scale,PSQI),the compression number of patient-controlled analgesia pump(PCA),nursing quality satisfaction,and postoperative length of stay were compared and analyzed.Results The pain scores of the observation group at 0,4,12,and 24 h after intervention[(6.21±0.74)points,(4.62±0.61)points,(3.28±0.75)points,and(2.18±0.47)points]were significantly lower than those of the control group,and the differences were statistically significant(P<0.05).The total score of nursing satisfaction in observation group[(13.70±0.85)points]was higher than that in control group[(12.02±1.32)points],and the difference was statistically significant(P<0.01).Sleep quality scores of the observation group[(4.55±1.23)points(4.72±0.56)points(2.45±0.87)points]at 12 h,24 h,and 48 h after intervention were higher than those of the control group,and the differences were statistically significant(P<0.01).The frequency of PCA compression in the observation group[(0.37±0.49)times,(0.40±0.49)times,and(0.50±0.50)times]at 8 h,12 h,and 24 h after interventionwere lower than those in the control group,and the differences were statistically significant(P<0.01).The number of patients in the observation group who were hospitalized for less than 3 days[29(72.5%)]was higher than that in the control group[11(27.5%)],while the number of patients in the observation group who were hospitalized for more than 3 days was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The application of advanced analgesia concept in patients after LC has significant effects on reducing postoperative pain,improving postoperative sleep quality,reducing the number of PCA compressions,improving nursing satisfaction,and shortening the length of hospitalization,and has high clinical application value.