腹腔镜术后内脏痛相关机制及治疗研究进展

Research progress on the mechanism and treatment of visceral pain after laparoscopic surgery

腹腔镜手术后除躯体创伤疼痛,部分患者还可能经历痛苦的术后内脏痛,不仅使患者术后体验不佳,疼痛应激甚至可能加重机体的内环境紊乱,不利于患者的术后康复。内脏痛是来源于内脏器官和组织的疼痛,其产生与脏器的平滑肌痉挛、扩张、缺血、化学炎症刺激等密切相关。在这个过程中,许多离子通道和受体在调节内脏伤害性刺激信号的传导上发挥作用。目前,临床上术后镇痛治疗方案多样,但如何针对性地控制术后内脏痛是临床医生需要面对和解决的问题。为此,该文对腹腔镜术后内脏痛发生的相关机制、内脏感觉的神经传导及临床特征、治疗进展进行综述。

In addition to physical trauma,patients undergoing laparoscopic surgery may also experience postoperative visceral pain.This pain not only impacts the patient’s postoperative experience,but can also worsen the body’s internal environment and hinder recovery.Visceral pain originates from internal organs and tissues.It is closely related to smooth muscle spasms,dilations,ischemia,and chemical inflammatory stimulation of organs.In this process,numerous ion channels and receptors regulate the transmission of visceral nociceptive stimulus signals.At present,there are multiple clinical treatment options available for postoperative pain management.However,clinicians must overcome the challenge of controlling postoperative visceral pain.This article provides a review of the relevant mechanisms of visceral pain following laparoscopic surgery,the neural conduction of visceral sensation,clinical characteristics and treatment advancements.