无痛病房管理模式下根治性全胃切除术患者出院后的疼痛随访分析

Analysis on pain after discharged in patients with radical total gastrectomy under painless ward management

目的调查无痛病房管理模式下根治性全胃切除术患者出院后的疼痛情况,分析出院后患者的疼痛病因并指导治疗策略。方法回顾性分析2016年12月至2017年4月期间空军军医大学第一附属医院消化外科收治的82例因胃癌行根治性全胃切除术患者的疼痛资料,了解其出院后第2周,以及第1、2及3个月的疼痛发生情况。结果出院后第2周25例患者发生轻度疼痛;出院后第1个月38例患者发生轻度疼痛,7例患者发生中度疼痛;出院后第2个月31例患者发生轻度疼痛,4例患者发生中度疼痛;出院后第3个月19例患者发生轻度疼痛。出院后第2周,以及第1、2及3个月时,男性和女性、<60岁和≥60岁、手术时间<180 min和≥180 min、术中出血量<200 mL和≥200 mL患者的疼痛评分比较差异均无统计学意义(P>0.05)。结论无痛病房管理模式下根治性全胃切除术患者出院后的疼痛控制良好。

Objective To explore the pain after discharged in patients with radical total gastrectomy under painless ward management, and to analyze the causes of pain in order to guide the treatment strategy after discharge. Methods Retrospective analysis was performed on the pain data of 82 patients who underwent radical total gastrectomy in The First Affiliated Hospital of Air Force Military Medical University from December 2015 to April 2017, and the situation of pain was followed-up at 2 weeks, 1 month, 2 months, and 3 months after discharged. Results Mild pain occurred in 25 patients at the 2 weeks after discharged; mild pain occurred in 38 patients and moderate pain occurred in7 patients at the first month after discharged; mild pain occurred in 31 patients and moderate pain occurred in 4 patients at the second month after discharged; 19 patients had mild pain at the third month after discharged. There was no significant difference in pain scores between male patients and female patients, 〈60 years old patients and ≥60 years old patients, patients＇ operative time〈180 min and patients＇ operative time ≥180 min, patients＇ intraoperative blood loss〈200 mL and patients＇ intraoperative blood loss ≥200 mL at the all time points, including the second week, the first, the second, and the third month after discharge （ P〉0.05）. Conclusion Painless ward management can effectively control the degree of pain in discharged patients who underwent radical total gastrectomy.