腹腔镜直肠前切除术与开腹手术对患者术后疼痛影响的比较

The influence of laparoscopic anterior resection of rectal cancers on postoperative pain compared with open surgery

目的:对比腹腔镜与开腹直肠前切除术对患者术后疼痛的影响。方法:将110例直肠癌根治术患者随机分为两组,腹腔镜组(n=56)行腹腔镜辅助下直肠前切除术,开腹组(n=54)行传统开腹直肠前切除术。对比分析两组患者术后不同时段疼痛程度、睡眠质量、术后止痛药的使用剂量及住院时间。结果:术后6 h、24 h及48 h,腹腔镜组疼痛评分显著低于开腹组(P<0.01);术后72 h,两组患者疼痛评分差异无统计学意义(P>0.05)。腹腔镜组住院时间、止痛药使用剂量明显少于开腹组(P<0.01),术后当天及术后第1天、第2天睡眠质量明显优于开腹组(P<0.01)。术后第3天,两组患者睡眠质量差异无统计学意义(P>0.05)。结论:腹腔镜辅助下直肠癌根治术可有效降低术后疼痛程度,提高患者的睡眠质量,减少住院时间,有效促进了患者的早期康复。

Objective：To compare the influence of laparoscopic anterior resection of rectal cancers and open surgery on postoperative pain. Methods：One hundred and ten patients were randomly assigned to 2 groups：patients in group A（n = 56） underwent laparoscopic anterior resection of rectal cancer;patients in group B（ n = 54） underwent traditional open anterior resection. A comparative study was made between the two groups in terms of postoperative pain level at different time period,the sleep quality,the dose of analgesics,the hospital stay and so on. Results：The pain scores in group A were significantly less than those in group B at the 6 h,24 h and48 h after operation（ P〈0. 01）. The pain scores in group A and B at the 72 h after operation were not statistically different（ P〉0. 05）. The dose of analgesics and the hospital stay in group A were significantly less compared to group B（ P〈0. 01）. The sleep quality of the operative day,the first and second day after operation in group A was better than that in group B（P〈0. 01）,while was similar between the two groups on the 3rd day after operation（P〉0. 05）. Conclusions：The laparoscopic-assisted radical operation for rectal cancer can decrease postoperative pain and the hospital stay,improve the sleep quality and early recovery.