基于加速康复外科理念的疼痛管理模式在肝癌围术期的应用研究

Study on application of pain management model based on enhanced recovery after surgery in perioperative period of liver cancer

目的:探讨加速康复外科理念(enhanced recovery after surgery,ERAS)的疼痛管理模式在肝癌围术期的应用及效果评价。方法:选取2019年1月至2019年12月在我院行肝癌切除术的168例患者为研究对象,根据疼痛管理模式的不同,分为观察组和对照组。其中,观察组86例在围术期采用基于ERAS的疼痛管理模式干预,对照组82例采用传统的围术期疼痛管理模式,比较两组患者术后疼痛评分、睡眠质量、疼痛控制满意度、早期下床活动时间、肠道通气时间、住院时间、住院费用等之间的差异。结果:观察组患者术后疼痛评分低于对照组,术后睡眠质量显著优于对照组,镇痛效果的满意度也高于对照组,差异均有统计学意义(P<0.05)。观察组早期下床时间、肠道通气时间、平均住院日均较对照组提前,住院费用也显著低于对照组(P<0.05)。结论:基于ERAS下的疼痛管理模式能有效降低肝癌患者术后疼痛程度,干预后,患者肠道通气与下床时间均提前,术后恢复快,住院日缩短,对疼痛的控制更满意。

Objective:To investigate the application and effect evaluation of the pain management model of of enhanced recovery after surgery(ERAS)in the perioperative period of liver cancer patients.Methods:168 patients who underwent hepatectomy in our hospital from January 2019 to December 2019 were divided into observation group and control group according to different pain management patterns,with 86 cases in observation group and 82 cases in control group.Patients in the observation group were treated with the pain management model intervention based on ERAS during the perioperative period,while patients in the control group were treated with traditional perioperative pain management model.The differences of postoperative pain score,sleep quality,satisfaction of pain control,postoperative prophase time of getting out of bed and exhaust,hospitalization time and hospitalization expenses in the two groups were compared.Results:The postoperative pain score of the observation group was lower than that of the control group,with statistically significant difference(P<0.05).The postoperative sleep quality of the observation group was significantly better than that of the control group(P<0.05).The satisfaction degree of analgesic effect was also higher than that of the control group,with statistically significant difference(P<0.05).The postoperative prophase time of getting out of bed and exhaust and the average daily average hospitalization days of observation group were earlier than those of the control group.And the hospitalization expenses was significantly lower than that of the control group.Conclusion:The pain management model based on ERAS can effectively reduce the postoperative pain degree of liver cancer patients.After the intervention,postoperative prophase time of getting out of bed and exhaust are advanced.The postoperative recovery is faster,reducing hospitalization days.And the control of pain is more satisfactory,achieving the purpose of ERAS.