疼痛管理对腹腔镜结肠癌根治术后早期康复的影响

Effect of pain management on early recovery after laparoscopic radical resection of colon cancer

目的:研究术后疼痛管理对腹腔镜结肠癌根治术后患者早期康复的影响。方法:将符合纳入标准的112例腹腔镜结肠癌根治术患者随机分为干预组(n=58)与对照组(n=54),干预组术前予以镇痛管理及早期下床活动宣教,术后予以镇痛泵、镇痛药物,每6 h进行疼痛评估,根据疼痛评分进行方案、剂量的调整。术后每4 h根据下床活动标准对患者进行评估,达到标准的患者根据术后早期下床活动方法进行活动;对照组施行围手术期常规治疗。对比分析两组患者术后24 h内下床活动例数、下床活动前后疼痛评分、首次下床时间、首次下床活动时长、首次排气时间、疼痛控制满意度、术后住院时间等。结果:干预组24 h内下床活动例数、下床活动前后疼痛评分、满意度、首次下床时间、首次排气时间、出院时间均优于对照组,差异有统计学意义(P<0.05)。两组患者首次下床活动时长差异无统计学意义(P>0.05)。结论:开展疼痛管理能促进腹腔镜结肠癌根治术后患者早期下床活动,推进加速康复外科的开展,促进患者术后早期康复。

Objective:To study the effect of postoperative pain management on the early recovery of patients after laparoscopic radical resection of colon cancer.Methods:One hundred and twelve patients were randomly divided into intervention group(n=58)and control group(n=54).Preoperative analgesia management and early ambulation education were given to the intervention group,after the operation the pain level of patients was evaluated every 6 h,and the scheme and dose of analgesic pump and drugs were adjusted according to the pain score.Every 4 hours after operation,the status of patients was evaluated according to the ambulation standard,and the patients who met the standard received early mobilization under guidance.Control group received traditional perioperative treatment.The number of patients with successful ambulation within 24 h,pain score before and after ambulation,time of first ambulation,period of first ambulation,time of first anal exhaust,satisfaction of pain control,postoperative hospital stay were compared between the 2 groups.Results:The number of patients who got out of bed within 24 h,pain score before and after getting out of bed,degree of satisfaction,time of getting out of bed for the first time,time of exhausting air for the first time,and time of discharge in the intervention group were all better than those in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in duration of the first ambulation between the two groups(P>0.05).Conclusions:Pain management can promote the early ambulation,promote the development of enhanced recovery after surgery,and promote the early recovery of patients.