无痛治疗在肛肠科围手术期应用分析

Application of painless treatment in perioperative period of anorectal surgery

目的探讨无痛治疗在肛肠科围术期患者中应用的效果。方法 200例肛肠手术患者随机分为研究组和对照组,研究组100例采用多模式镇痛的无痛治疗,对照组100例采用术后疼痛不能耐受时口服塞来昔布或肌注曲马多治疗。对两组患者术后6 h疼痛评分、24 h疼痛评分、48 h疼痛评分、术后第5天疼痛评分、首次排便时疼痛评分、满意度评分等指标进行分析比较。结果研究组患者术后6 h疼痛评分(3.6±0.6),对照组术后6 h疼痛评分(3.7±0.3),两组比较差异无统计学意义(P>0.05),术后24 h疼痛评分(2.7±0.9)分、48 h内疼痛评分(4.3±0.4)分、第5天疼痛评分(3.1±0.6)、首次排便时疼痛评分(5.7±1.5)分,均低于对照组(5.9±0.2)、(5.6±1.3)、(6.3±0.4)、(8.9±1.5),差异有统计学意义(P<0.05);研究组满意度评分(4.6±0.3)分,高于对照组(3.4±0.6),差异有统计学意义(P<0.05)。结论肛肠科围手术期患者实施多模式镇痛的无痛治疗,可以有效减轻患者术后疼痛、提高患者的生活质量。

Objective To evaluate the effect of painless treatment in perioperative period of anorectal surgery. Methods A total of 200 patients with anorectal surgery were randomly divided into an experimental group and a control group. The experimental group （n = 100） was treated with painless multimodal analgesia. The control group （n = 100） was treated with oral celecoxib or intramuscular tramadol. The pain scores of postoperative 6 h,24 h,48 h,5 d,and first defecation,as well as the satisfaction score,of the two groups were compared. Results The pain score of postoperative 6 h of the experimental group was （3.6 ±0. 6）,and that of the control group was （3. 7 ±0. 3）,showing no statistical difference （_P 〉0. 05）. The pain scores of postoperative 24 h （2.7 ±0.9）,48 h （4.3 ±0.4）,5 d （3.1 ±0.6）,and first defecation （5.7 ±1.5） of the experimental group were lower than those of the control group [（5.9 ± 0 .2 ）, （5.6 土 1.3）, （6.3±0.4） ,and （8. 9 ± 1.5 ）, respectively ],and the difference was statistically significant （P 〈 0. 05）. The satisfaction score of the experimental group （4. 6 ± 0. 3） was higher than that of the control group （3.4 ±0.6） （ P 〈 0. 05）. Conclusion Painless treatment for perioperative anorectal patients using multimodal analgesia can effectivelyreduce postoperative pain and improve quality of life.