胸腔镜与开胸肺叶切除术后患者慢性疼痛的对比研究

Comparison of chronic pain after open versus minimally invasive approach for patients who received lobectomy

目的比较完全胸腔镜与常规开胸施行肺叶切除术后患者急、慢性疼痛的发生情况及其相互关系。方法分析2015年9月至2015年12月我院接受肺叶切除术的90例患者。45例接受微创手术,45例接受开放手术。观察术后72h内急性疼痛和术后1、2、3、6个月慢性疼痛发生情况。结果在术后4 h、6 h、12 h、24 h、48 h、72 h急性疼痛评分方面,微创组患者均显著低于开放组(P<0.05)。微创组术后疼痛持续1、2、3、6个月时的发生率均较开放手术组低(P<0.05)。结论相对于开胸手术,胸腔镜肺叶切除术在术后急、慢性疼痛方面均存在优势。术后慢性疼痛与早期急性疼痛的程度和处理方式相关。

Objective To explore the correlation of acute and chronic pain in patients after lobectomy,and to compare the differences between thoracoscope and thoracotomy.Methods The clinical data of 90 patients who re-ceived lobectomy from September 2015 to December 2015 were analyzed retrospectively.45 cases were given mini-mally invasive approach and another 45 cases underwent open lobectomy.NRS scores were recorded in the first 72 h after operation.The occurrence of chronic pain was observed at the first,second,third and sixth months after opera-tion.Results NRS scores in the first 72 h after operation were significantly lower in the minimally invasive group than in the open group （P 〈0.05）.The occurrence of pain after operation was lower in the minimally invasive group than in the open group in the first,second,third and sixth months （P 〈0.05）.Conclusion Compared with open lobectomy,minimally invasive lobectomy has the advantages of lower incidence and lesser degree of chronic pain. Chronic pain is associated with the intensity and management of acute pain after operation.