预防性镇痛对进展期胃癌患者术后恢复的影响

Effect of preventive analgesia on postoperative recovery of patients with advanced gastric cancer

目的:探讨预防性镇痛方案对进展期胃癌患者术后康复的影响。方法:采用前瞻性随机对照研究的方法,选取2021年2月至2022年3月行腹腔镜辅助胃癌根治术的88例进展期胃癌患者,按随机数字表法随机分为实验组(n=45,施行预防性镇痛措施)与对照组(n=43,施行传统镇痛措施)。记录比较两组术后恢复情况、术后疼痛评分、术后镇痛药物追加情况、炎性应激反应指标、术后并发症情况等。结果:实验组术后第1天、第2天、第3天下床活动时间长于对照组,差异有统计学意义(P<0.05);术后排气时间、排便时间、住院时间、住院费用、术后追加镇痛药物次数、镇痛泵按压次数、恶心呕吐发生率均少于对照组,差异均有统计学意义(P<0.05)。术后第1天、第2天、第3天疼痛评分低于对照组(P<0.05)。两组术后并发症总发生率差异无统计学意义(P>0.05)。术后第3天、第5天试验组患者C-反应蛋白、肿瘤坏死因子-α、白细胞介素-6低于对照组(P<0.05)。结论:进展期胃癌患者围术期采用预防性镇痛方案,可有效减轻术后疼痛,促进胃肠功能的恢复,加速患者术后早期康复。

Objective:To investigate the effect of preventive analgesia on postoperative rehabilitation of patients with advanced gastric cancer.Methods:The prospective randomized controlled study was conducted.Eighty-eight advanced gastric cancer patients who accepted laparoscopic assisted radical surgery for gastric cancer from Feb.2021 to Mar.2022 were enrolled.They were assigned into e xperimental group and control group in accordance with the random number table.45 patients in the experimental group were given preventive analgesia;43 cases in the control group were given traditional analgesic measures.The postoperative recovery,postoperative pain score,postoperative analgesic drug addition,inflammatory stress reactive indicators and incidence of postoperative complications in the two groups were recorded and compared.Results:The postoperative ambulation time in the experimental group were significantly l onger than that in the control group on postoperative day 1,2 and 3,with statistically significant difference(P<0.05).The postoperative flatus time,defecation time,hospital stay,hospitalization cost,times of additional analgesic drugs,analgesic pump pressing times,the incidence of nausea and vomiting in the experimental group were significantly less than those in the control group,with statistically s ignificant difference(P<0.05).The pain scores on postoperative day 1,2 and 3 in the experimental group were significantly fewer than those in the control group(P<0.05).There was no significant difference in the incidence of postoperative total complications b etween the two groups(P>0.05).The C-reactive protein,tumor necrosis factor-α,and interleukin-6 in the experimental group on the postoperative third and fifth day were significantly lower as compared to the control group(P<0.05).Conclusions:Preventive analgesia in the perioperative treatment of patients with advanced gastric cancer could relieve postoperative pain,improve the intestinal function recovery and enhance the early rehabilitation of patients after operation.