参麦注射液减轻子宫切除患者术后疲劳的效果观察

Effects of Shenmai Injection on Postoperative Fatigue in Hysterectomy Patients

目的观察围术期应用参麦注射液减轻妇科子宫切除患者术后疲劳效果。方法将66例拟行腹腔镜下子宫切除术患者,随机分为对照组(C组)和参麦组(SM组),SM组于切皮前静脉滴注参麦注射液0.6 mL/kg,C组给予等量生理盐水。测定术前、术后4 h、术后1、2天握力及肌耐力,术前、术后2、5、15、30天的疲劳程度[视觉模拟评测表(Visual Analog Scale,VAS);围术期疲劳测评量表(Identity-Consequence Fatigue Scale,ICFS)],记录术后肛门排气天数、术后首次下床时间、住院天数、恢复工作时间,术后1、 2天40项术后恢复质量评分(40-Item Quality of Recovery,QoR-40),评估术后恶心、呕吐等不良情况。结果患者握力、肌耐力较术前降低,C组降低更明显(P<0.01);患者术后各时点VAS、ICFS评分均高于术前(P<0.01),C组VAS、ICFS评分较SM组更高(P<0.01);SM组术后首次下床时间、恢复工作时间早于C组(P<0.05,P<0.01),术后1、2天QoR-40评分高于C组(P<0.01),两组肛门排气时间、住院天数及恶心、呕吐等不良情况比较,差异无统计学意义(P>0.05)。结论手术前静脉滴注参麦注射液,能有效地改善腔镜子宫切除患者术后握力和肌耐力,减轻术后疲劳,较早恢复日常工作时间。

Objective To observe the effect of Shenmai Injection(SM)on perioperatively reducing postoperative fatigue in patients with gynecological hysterectomy.Methods Totally 66 patients undergoing laparoscopic hysterectomy were randomized into a control group(C)and SM group.Patients in the SM group were intravenously injected with SM(0.6 mL/kg)before skin incision.Those in the C group were given the same amount of normal saline.Grip strength and grip work were measured preoperatively,4 h,1,2 days after surgery.The fatigue degrees before surgery,2,5,15,and 30 days after operation were assessed by Visual Analog Scale(VAS)and Identity-Consequence Fatigue Scale(ICFS).The time to first passage of flatus,the time of getting off the bed,the postoperative hospital stay time,the postoperative recovery working time,and 40-Item Quality of Recovery(QoR-40),post-surgical 1 and 2 days were recorded.Postoperative nausea,vomiting and other adverse reactions were assessed.Results The grip strength and grip work of both groups decreased in the two groups compared with those before operation,and the decrease was more obviously seen in the C group(P<0.01).The fatigue scores assessed by VAS and ICFS at each time point after operation were higher in the two groups after operation than before operation(P<0.01),and they were more obvious seen in the C group than in the SM group(P<0.01).Compared with the C group,the time off the bed and recovery time after operation were earlier(P<0.05,P<0.01),and the scores of QoR-40 at post-operative 1 and 2 days were higher(P<0.01)in the SM group.There was no significant difference in first passage of flatus time,postoperative hospital stay,postoperative nausea,vomiting and other adverse reactions between the two groups(P>0.05).Conclusion Intravenous dripping SM effectively improved postoperative grip strength and grip work of hysterectomy patients,reduced postoperative fatigue,and resumed routine work as earlier as possible.