多模式镇痛在腹腔镜胃癌手术疼痛管理中的应用研究

Application of multi-mode analgesia in pain management of laparoscopic gastric cancer surgery

目的:探讨多模式镇痛在腹腔镜胃癌手术疼痛管理中的临床效果。方法:选取2015年5月至2016年11月收治的40例腹腔镜胃癌手术患者作为对照组,另选取2017年1月至2018年7月40例腹腔镜胃癌手术患者作为试验组。对照组行常规疼痛管理措施,试验组在接受常规疼痛管理措施的基础上,施行多模式镇痛方案。采用数字评分法(NRS)评估患者静息及活动状态的疼痛,采用中文版功能活动评分法(FAS)评估患者活动时的疼痛,并根据评估结果实施多模式镇痛方案。结果:试验组患者术后8 h、16 h、24 h、32 h、48 h、72 h静息NRS评分低于对照组,差异有统计学意义(P<0.05);试验组术后3 d内FAS等级评价优于对照组,差异有统计学意义(P<0.05);试验组活动NRS评分低于对照组,差异有统计学意义(P<0.05);试验组术后总活动时间、距离、活动频次均优于对照组(P<0.05);试验组术后首次排便时间短于对照组(P<0.05)。结论:多模式镇痛可有效减轻患者疼痛程度,提高疼痛管理质量,增强术后活动的积极性,加快康复。

Objective:To explore the clinical effect of multi-mode analgesia in pain management of laparoscopic gastric cancer surgery.Methods:From May 2015 to Nov.2016,40 patients undergoing laparoscopic gastric cancer surgery were selected as control group.From Jan.2017 to Jul.2018,40 patients undergoing laparoscopic gastric cancer surgery were selected as the trial group.The control group received routine pain management measures.The trial group received a multi-mode analgesic regimen on the basis of routine pain management.Numerical rating scale(NRS)was used to evaluate the pain of resting state and active state.The Chinese version of the functional activity scale(FAS)was used to evaluate the pain of patients during activity,and a multi-mode analgesic scheme was implemented according to the results of the evaluation.Results:The resting NRS scores of 8 h,16 h,24 h,32 h,48 h and 72 h after operation in the trial group were lower than those in the control group,and the difference between the two groups was statistically significant(P<0.05).The evaluation of FAS grade in the trial group was better than that in the control group within 3 d after operation,and the difference between the two groups was statistically significant(P<0.05).The active NRS score of the patients in the trial group was lower than that in the control group,and the difference was statistically significant(P<0.05).The total time,distance and frequency of postoperative activity in the trial group were better than those in the control group(P<0.05).The first defecation time in the trial group was shorter than that in the control group(P<0.05).Conclusions:Multi-mode analgesia can effectively reduce the degree of pain,improve the quality of pain management,enhance the enthusiasm of postoperative activities,and accelerate the recovery of patients.