乳房整形美容术后早期疼痛的临床特征研究

Clinical characteristics of early pain after breast plastic surgery

目的调查三类乳房整形美容手术后早期患者疼痛的临床特征,为优化疼痛管理方案提供依据。方法收集2021年11月至2022年8月收治的72例行隆乳术、乳房缩小成形术、乳房悬吊术的患者资料,于术后1 d、2 d、3 d分别记录疼痛水平(数字疼痛评分、修订版面部表情疼痛评估法)、疼痛部位、伴随症状、用药情况,分析疼痛的临床特征。结果术后1~3 d的疼痛水平总体呈现下降趋势。隆乳术后的患者疼痛水平最高,持续处于中等疼痛水平,疼痛部位以腋下(68.60%)、乳房上方(49%)居多;乳房缩小成形术、乳房悬吊术后患者的疼痛部位以乳房下缘(33.30%)、乳晕(33.30%)和乳房外侧(26.70%)为主,部分位置的双侧乳房疼痛发生率不一致。多数患者不伴有其他症状。58.33%的患者在术后1 d使用1种药物镇痛,37.5%的患者在术后2 d使用2种及以上药物镇痛,76.39%的患者在术后3 d无需使用药物。结论隆乳术后患者的早期疼痛值得重点关注,疼痛发生位置主要与切口、引流留置、假体植入、血肿发生有关。在评估疼痛时应关注双侧乳房疼痛的区域特征,识别疼痛原因,尽早发现并预防血肿。镇痛药物的选择应避免同机制药物的叠加使用,实施多模式镇痛,联合非药物干预措施,共同管理疼痛及药物不良反应。

Objective To investigate the clinical characteristics of pain in the early stage after three types of breast plastic surgery,and to provide basis for optimizing the pain management plan.Methods From November 2021 to August 2022,72 patients who underwent breast augmentation,mammaplasty and breast suspension were included.The pain level(digital pain score,revised facial expression pain assessment method),site,concomitant symptoms and medication were collected on the 1st,2nd and 3rd day after surgery,and the clinical characteristics of pain were analyzed.Results The pain level showed a downward trend 1-3 days after operation.Patients who underwent breast augmentation had the highest pain levels,and sustained moderate pain levels.The pain sites were mainly under the armpit(68.60%)and above the breast(49%).The pain sites after breast reduction surgery and breast suspension surgery were mainly at the lower edge of the breast(33.30%),areola(33.30%),and lateral breast(26.70%).The incidence of bilateral breast pain in partial locations was inconsistent.Most patients had no other symptoms.58.33%of patients used one drug for analgesia on the first day after operation,37.5%of patients used two or more drugs for analgesia on the second day after operation,and 76.39%did not use drugs on the third day after operation.Conclusion The early pain of patients after breast augmentation deserves attention.The location of pain is mainly related to incision,drainage retention,prosthesis implantation and hematoma.When assessing pain,medical staff should pay attention to the regional characteristics of bilateral breast pain,identify the cause of pain,and detect and prevent hematoma as soon as possible.The choice of analgesics should avoid the overlapping use of drugs with the same mechanism,implement multimodal analgesia,combine non-drug intervention,and jointly manage pain and adverse drug reactions.