阻塞性睡眠呼吸暂停低通气综合征患者舌根射频消融术后疼痛观察

Pain in patients with obstructive sleep apnea hypopnea syndrome after tongue base radiofrequency ablation

目的观察并归纳阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患者舌根射频术后疼痛规律。方法对39例OSAHS患者行舌根射频术治疗,运用视觉模拟评分法(visualanalogue score,VAS)记录患者术后0、1、2、4、8、10、12、24、48、72、96、120小时疼痛情况并进行评价,同时记录是否使用双氯芬酸钠栓止痛。结果39例中符合填写要求的32例,3例患者填写不规范、4例患者使用了双氯芬酸钠栓。符合填写要求的32例患者中,约87.5%的患者术后即时出现疼痛,在术后1～4小时约有62.5%的患者可达到峰值,然后逐渐减轻,疼痛持续在3天以上的约占96.9%。患者平均峰值疼痛程度VAS评分为6.34±2.38,89.7%的患者可以耐受疼痛,10.3%的患者需要使用双氯芬酸钠栓止痛。结论OSAHS患者舌根射频术后疼痛多表现为舌根钝性疼痛,可放射到咽侧、下颌下及耳部。疼痛在术后第1天内波动较剧烈,高峰约出现在术后1～4小时,然后逐渐减轻,一般持续3天以上。平均峰值疼痛程度为中重度,大多数患者可以耐受,少数患者需给予双氯芬酸钠栓止痛。

OBJECTIVE To observe the pattern of postoperative pain in adult patients with obstructive sleep apnea hypopnea syndrome（OSAHS）after tongue base radiofrequency ablation.METHODS The tongue base radiofrequency ablation was performed on 39 OSAHS patients.The visual analogue score（VAS） was used to record the level of postoperative pain in patients at 0,1,2,4,8,10,12,24,48,72,96,120h after operation.The usage of diclofenac suppository was also recorded.RESULTS Three cases were excluded for unfinished filling in the VAS.Of the other 32 cases,four cases used diclofenac suppository.The pain occurred immediately in 87.5% of patients after operation.The peak tracked by VAS was found in 62.5% of patients at 1 to 4 hours after operation,and then subsided gradually.In 96.9% of patients,the pain continued for more than 3 days.The average peak of pain by VAS score was 6.34 ±2.38.89.7% of patients could tolerate the pain,10.3% of patients need to use diclofenac suppository.CONCLUSION Tongue base blunt pain was the common complaint in most OSAHS patients after tongue base radiofrequency ablation.And the pain radiates to the pharyngeal wall,submandibular area and ears.The relative dramatic fluctuation of the pain was found in the first days after the operation.The peak time of the pain appears at 1～4 hours after the treatment,and then gradually reduced.The pain continues for more than 3 days.The average peak postoperative pain tracked by VAS score was moderate or severe.The postoperative pain could be tolerated in most patients.A small number of patients need to use diclofenac suppository to relieve the pain.