输尿管镜术后24h内疼痛的量化分析与处理

Quantificational analysis and management of pain within 24 h following ureteroscopy

目的量化评估输尿管镜术后24 h内患者的疼痛程度,分析其原因并依量化程度给予相应处理。方法收集该院2008年1月～2010年5月输尿管镜术后187例患者的疼痛资料,通过线形视觉模拟标尺评分法(VAS)量化疼痛程度,分析疼痛原因并给予有效处理。结果输尿管镜术后24 h内患者多有肾区、输尿管行径区、下腹部疼痛,一般为轻、中度疼痛。术后24 h内疼痛165例(88.2%),VAS疼痛评分为(3.87±1.63)分,手术时间为(50.85±23.03)min,治疗后总VAS值为(1.08±0.99)分。依据量化程度,分析其原因并给予相应的处理均能缓解。结论输尿管镜术后24 h内疼痛多与手术操作有关,疼痛量化程度与手术时间呈正相关;治疗前后疼痛值比较差异有显著性(P<0.05)。依据疼痛量化程度,正确分析原因,大多经心理指导和药物辅助治疗后缓解。

[ Objective ] To quantificationally evaluate the extent of the pain within 24h of ureteroscopy as well as analyzing the causes of pain and following relevant management. [ Methods ] From January 2008 to May 2010, the medical records of 187 in patients underwent ureteroscopy were reviewed retrospectively. The postoperative pain measured by visual analogue scales （VAS） as well as their treatment was analyzed. [ Results ] Lumbago, ureter track pain and hypogastric pain at whiles happened in patients within 24h after ureteroscopy. Most of the postoperative pain was low-to-medium grade. Among the 187 cases, postoperative pain within 24h after ureteroscopy was found in 165 ones （88.2%） whose mean visual analogue scales （VAS） score for pain was 3.87±1.63. They took favorable man- agement aiming at the cause of postoperative pain. [ Conclusion] Postoperative pain within 24h is related with ureteroscopy. Quantificational extent of pain has a direct correlation with duration of surgery. Most of the postopera- tive pain can be treated with the instruction of urination and conservative drug treatment by correctly analyzing the causes of postoperative pain and evaluating quantificational extent of the pain. The key to decrease postoperative pain after ureteroscopy is experienced and soft operation.