快速康复理念下多模式镇痛对食管癌患者术后疼痛控制效果的探讨

Effect of multi-mode analgesia based on rapid recovery concept on postoperative pain control in patients with esophageal cancer

目的分析快速康复理念下多模式镇痛对食管癌患者术后疼痛控制效果。方法选取2020年4月至2021年3月在高州市人民医院行胸腹腔镜联合下食管癌根治术患者100例,采用抽签法分为对照组和观察组,每组50例。对照组男27例,女23例,年龄36~82(49.68±11.26)岁。观察组男26例,女24例,年龄35~81(48.26±11.67)岁。对照组采用常规镇痛方式,观察组采用快速康复理念下多模式镇痛。对比两组患者疼痛情况、并发症发生率、负性情绪,术后住院天数、排气等指标以及镇痛满意度。计量资料组间比较采用独立样本t检验,计数资料组间比较采用χ^(2)检验。结果观察组首次排便时间、首次排气时间、首次下床时间以及住院天数均低于对照组(均P<0.001)。观察组术后1、2、3、7 d视觉模拟评分法(VAS)评分均低于对照组(均P<0.001)。术后观察组焦虑自评量表(SAS)、抑郁自评量表(SDS)评分均低于对照组[(38.69±4.23)分比(56.89±4.32)分、(41.65±4.12)分比(52.65±4.56)分],差异均有统计学意义(均P<0.001)。观察组术后并发症发生率低于对照组[4.0%(2/50)比16.0%(8/50)],观察组镇痛满意度高于对照组[96.0%(48/50)比84.0%(42/50)],两组比较差异有统计学意义(χ^(2)=4.215,P=0.040)。结论食管癌患者术后采用快速理念下多模式镇痛,可有效缓解患者负性情绪、改善术后疼痛,提高恢复效果,缩短患者住院时间。

Objective To analyze the effect of multi-mode analgesia based on rapid recovery concept on postoperative pain control in patients with esophageal cancer.Methods A total of 100 patients undergoing thoracic laparoscopy and esophageal cancer radical resection in Gaozhou People's Hospital from April 2020 to March 2021 were selected and divided into a control group and an observation group by the lottery method,with 50 cases in each group.There were 27 males and 23 females in the control group,and they were 36-82(49.68±11.26)years old.There were 26 males and 24 females in the observation group,and they were 35-81(48.26±11.67)years old.The control group were treated with conventional analgesia,and the observation group with multi-mode analgesia based on rapid recovery concept.The pain,incidences of complications,negative moods,postoperative hospitalization days,exhaust,and other indicators and analgesic satisfaction were compared between the two groups.The measurement data were compared between these two groups by independent-sample t test,and the enumeration data byχ^(2) test.Results The first defecation time,the first exhaust time,the first time out of bed,and the length of hospitalization in the observation group were lower than those in the control group(all P<0.05).The scores of Visual Analogue Scale(VAS)1,2,3,and 7 days after the operation in the observation group were lower than those in the control group(all P<0.05).The scores of Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS)in the observation group were lower than those in the control group[(38.69±4.23)vs.(56.89±4.32)and(41.65±4.12)vs.(52.65±4.56);both P<0.05].The incidence of postoperative complications in the observation group was lower than that in the control group[4.0%(2/50)vs.16.0%(8/50),P<0.05].The analgesic satisfaction of the observation group was higher than that of the control group[96.0%(48/50)vs.84.0%(42/50)],with a statistical difference(χ^(2)=4.215,P=0.040).Conclusion Multi-mode analgesia based on rapid recovery concept for patients with esophageal cancer can effectively relieve their negative moods,improve their postoperative pain and the recovery effect,and shorten their hospital stay.