微波结合中流量吸氧减轻腹腔镜胆囊切除术后颈肩痛的效果

Clinical Effects of Microwave Combined with Median Flow Oxygenic Inhalation in Reliving Scapulodynia after Laparoscopic Cholecystectomy

目的探讨微波治疗结合中流量吸氧对控制腹腔镜胆囊切除(1aparoscopic video cholecystectomy,LC)术后颈肩痛的效果。方法采用随机对照试验方法,将200例患者随机分为A、B、C、D 4组,每组50例。A组术后给予吸氧2 L/min,6 h;B组吸氧4 L/min,6 h;C组在A组基础上给予微波治疗颈肩部;D组在B组基础上给予微波治疗颈肩部。检测A、B两组患者术后0.5、6.0 h的血气分析指标;依据模拟视觉评分对4组患者进行颈肩部疼痛评分。结果 D组患者术后颈肩痛的发生率最低(P<0.01),疼痛缓解最迅速;血气分析结果显示,B组患者术后6.0 h时PaO2高于A组患者,PaCO2、pH值低于A组患者,差异有统计学意义(P<0.05);提高吸氧流量和微波治疗均有助于缓解手术后颈肩痛,且两种干预措施之间存在交互作用(P<0.05)。结论适当提高吸氧流量有助于降低LC术后患者颈肩部疼痛的发生率,加用微波治疗可以加快缓解手术后的颈肩痛,两者之间有交互作用。

Objective To study the clinical effects of microwave combined with median flow oxygenic inhalation in reliving scapulodynia after laparoscopic cholecystectomy（LC）.Methods A total of 200 patients with LC were randomly divided into four groups according to the different flow oxygenic inhalation and with/without microwave treatment：group A（2 L/min,6 h,n=50）,group B（4 L/min,6 h,n=50）;group C（2 L/min,6 h,combined with microwave,n=50） and group D（4 L/min,6 h,combined with microwave,n=50）.Then the blood-gas analysis indexs（BGAI） at 0.5 and 6.0 h after treatment were analyzed in group A and group B.The pain scores of scapulodynia in the 4 groups were measured based on the visual analogue score.Results The incidence of scapulodynia after LC in group D was significantly lower than that in other 3 groups（P0.01）,and scapulodynia could be relieved fastest;The results of BGAI showed that PaCO2 at 6.0 h was higher in group B than that in group A,while PaO2 and pH value were lower in group B than those in group A（P0.05）.Both increased oxygen inhalation and microwave therapy could relieve scapulodynia after LC.A correlation was determined between the two intervention measures（P0.05）.Conclusion Appropriately increased oxygen inhalation helps decrease the incidence of postoperative scapulodynia after LC.Microwave combined with median flow oxygenic inhalation can accelerate the pain-relieving process of postoperative scapulodynia after LC.A correlation is determined between the two intervention measures.