肝胆外科手术患者术后疼痛及不良反应的影响因素分析

Influential factors of postoperative pain and adverse reactions in patients following hepatobiliary surgery

目的:探讨肝胆外科手术患者术后疼痛及不良反应的影响因素。方法:回顾性分析2018年3月至5月我院肝胆外科就诊并实施手术患者的临床资料。记录患者术后6 h、12 h的视觉模拟评分(VAS)及不良反应发生情况。分析患者性别、年龄、体质量指数、手术方式、手术时长、住院天数、麻醉方式、自控镇痛泵配方与术后疼痛、不良反应的关系。结果:共纳入患者410例,术后6 h VAS≥4分的患者占12.2%(50/410),术后12 h VAS≥4分的患者占7.8%(32/410),差异有统计学意义(χ~2=4.390,P<0.05)。手术时长、手术方式与术后6 h中重度疼痛有关,术后恶心呕吐与患者性别有关(均P<0.05)。Logistic回归显示手术时长与手术方式是肝胆外科手术患者术后中重度疼痛的危险因素(均P<0.05)。结论:手术时长与手术方式是肝胆外科手术患者术后中重度疼痛的危险因素,女性患者更容易发生术后恶心呕吐。

Objective:To investigate the influential factors of postoperative pain and adverse reactions in patients following hepatobiliary surgery.Methods:The clinical data of patients treated and undergoing hepatobiliary surgery in our hospital between March and May 2018 were retrospectively analyzed.Visual analogue scores(VAS)and adverse reactions were recorded at 6 and 12 hours after surgery.The relationship between gender,age,body mass index,surgical option,operation time,length of hospital stay,anesthesia,self-controlled analgesic pump formula and postoperative pain,adverse reactions were analyzed.Results:A total of 410 patients were included,VAS≥4 points was recored in 12.2%(50/410)of patients at 6 hours post-surgery,and in 7.8%(32/410)of patients at 12 hours post-surgery,with statistical difference(χ~2=4.390,P<0.05).The operation time and surgical option were associated with moderate-to-severe pain at 6 hours post-surgery;postoperative nausea and vomiting were associated with patient gender(bothP<0.05).Logistic regression showed that the operation time and surgical option were risk factors for moderate-to-severe pain after hepatobiliary surgery(bothP<0.05).Conclusion:The operation time and surgical option are risk factors for moderate-to-severe pain in patients following hepatobiliary surgery.Female patients are more prone to develop postoperative nausea and vomiting.