目的对比研究经脐单孔腹腔镜与多孔腹腔镜治疗妇科良性疾病术后肩膀疼痛情况及围手术期结局;通过比较术后肩膀疼痛组与非疼痛组的病例特征,分析腹腔镜术后肩膀疼痛的高危因素。方法采用回顾性队列研究,选取2022年4月—2023年3月因妇科...目的对比研究经脐单孔腹腔镜与多孔腹腔镜治疗妇科良性疾病术后肩膀疼痛情况及围手术期结局;通过比较术后肩膀疼痛组与非疼痛组的病例特征,分析腹腔镜术后肩膀疼痛的高危因素。方法采用回顾性队列研究,选取2022年4月—2023年3月因妇科良性疾病行腹腔镜手术的患者216例,根据入路不同分为单孔腹腔镜手术组(单孔组,108例)及多孔腹腔镜手术组(多孔组,108例)。采用视觉模拟评分(visual analogue scale,VAS)对两组术后24 h肩膀疼痛情况进行描述。比较两组术后肩膀疼痛情况及两组手术时间、术中出血量、术中腹腔CO_(2)进气量、术后住院时间、术后血红蛋白(hemoglobin,Hb)下降幅度、术后是否放置腹腔引流及术后是否放置镇痛泵等围手术期结局。采用Logistic回归分析比较术后肩膀疼痛组与非疼痛组的病例特征,分析造成腹腔镜术后肩膀疼痛的高危因素。结果单孔组术后肩膀疼痛评分明显高于多孔组(2.2 vs 0.7,P<0.001)。两组手术时间(96.5 min vs 95.1 min,P=0.08)、术中出血量(67.5 mL vs 50.1 mL,P=0.11)、术后住院时间(2.8 d vs 2.7 d,P=0.22)差异无统计学意义。单孔组术中CO_(2)进气量明显高于多孔组(181.9 L vs 123.2 L,P=0.002);单孔组术后放置腹腔引流的比例明显低于多孔组(62%vs 92.6%,P<0.001);单孔组术后Hb下降幅度高于多孔组(13.5 g/L vs 11.1 g/L,P=0.02)。通过比较腹腔镜术后肩膀疼痛组与非疼痛组的病例特征发现,低BMI(22.4 kg/m^(2) vs 23.4 kg/m^(2),P=0.04)及未放置腹腔引流(34.2%vs 16.8%,P<0.001)是造成腹腔镜术后肩膀疼痛的高危因素。结论在治疗妇科良性疾病方面,与传统腹腔镜相比,单孔腹腔镜同样安全有效,但是增加了患者术后肩膀疼痛的发生。BMI低的患者更容易发生腹腔镜术后肩膀疼痛,腹腔镜术后放置腹腔引流可以减少术后肩膀疼痛的发生。展开更多
Futu (LI 18) is an acupoint of the Large Intestinal Meridian of Hand-Yangming. Based on the TCM theories of Zang-fu organs and meridians together with the clinical practice for many years, the author has gained ne... Futu (LI 18) is an acupoint of the Large Intestinal Meridian of Hand-Yangming. Based on the TCM theories of Zang-fu organs and meridians together with the clinical practice for many years, the author has gained new experience in clinical use of the point. This is briefly introduced as follows.……展开更多
An analysis on 83 cases of posthemiplegic omalgia (shoulder pain) shows that the pathogenesis of the pain is closely related to the improper passive movement at the early stage of hemiplegia (62.7%). The large range o...An analysis on 83 cases of posthemiplegic omalgia (shoulder pain) shows that the pathogenesis of the pain is closely related to the improper passive movement at the early stage of hemiplegia (62.7%). The large range of passive movement is a dangerous factor leading to omalgia. In the study of upper extremity complications, the incidence of shoulder-hand syndrome is relatively high (42.2%), and it is often accompanied by hand swelling (83.1%). The authors suggest that painless movement of the shoulder joint should be limited in a range of 90-120 degrees, massage be carried out immediately after acupuncture, and the affected upper extremity be moved passively during the needle retention. This therapeutic method is definitely effective for pasthemiplegic omalgia.展开更多
文摘目的对比研究经脐单孔腹腔镜与多孔腹腔镜治疗妇科良性疾病术后肩膀疼痛情况及围手术期结局;通过比较术后肩膀疼痛组与非疼痛组的病例特征,分析腹腔镜术后肩膀疼痛的高危因素。方法采用回顾性队列研究,选取2022年4月—2023年3月因妇科良性疾病行腹腔镜手术的患者216例,根据入路不同分为单孔腹腔镜手术组(单孔组,108例)及多孔腹腔镜手术组(多孔组,108例)。采用视觉模拟评分(visual analogue scale,VAS)对两组术后24 h肩膀疼痛情况进行描述。比较两组术后肩膀疼痛情况及两组手术时间、术中出血量、术中腹腔CO_(2)进气量、术后住院时间、术后血红蛋白(hemoglobin,Hb)下降幅度、术后是否放置腹腔引流及术后是否放置镇痛泵等围手术期结局。采用Logistic回归分析比较术后肩膀疼痛组与非疼痛组的病例特征,分析造成腹腔镜术后肩膀疼痛的高危因素。结果单孔组术后肩膀疼痛评分明显高于多孔组(2.2 vs 0.7,P<0.001)。两组手术时间(96.5 min vs 95.1 min,P=0.08)、术中出血量(67.5 mL vs 50.1 mL,P=0.11)、术后住院时间(2.8 d vs 2.7 d,P=0.22)差异无统计学意义。单孔组术中CO_(2)进气量明显高于多孔组(181.9 L vs 123.2 L,P=0.002);单孔组术后放置腹腔引流的比例明显低于多孔组(62%vs 92.6%,P<0.001);单孔组术后Hb下降幅度高于多孔组(13.5 g/L vs 11.1 g/L,P=0.02)。通过比较腹腔镜术后肩膀疼痛组与非疼痛组的病例特征发现,低BMI(22.4 kg/m^(2) vs 23.4 kg/m^(2),P=0.04)及未放置腹腔引流(34.2%vs 16.8%,P<0.001)是造成腹腔镜术后肩膀疼痛的高危因素。结论在治疗妇科良性疾病方面,与传统腹腔镜相比,单孔腹腔镜同样安全有效,但是增加了患者术后肩膀疼痛的发生。BMI低的患者更容易发生腹腔镜术后肩膀疼痛,腹腔镜术后放置腹腔引流可以减少术后肩膀疼痛的发生。
文摘 Futu (LI 18) is an acupoint of the Large Intestinal Meridian of Hand-Yangming. Based on the TCM theories of Zang-fu organs and meridians together with the clinical practice for many years, the author has gained new experience in clinical use of the point. This is briefly introduced as follows.……
文摘An analysis on 83 cases of posthemiplegic omalgia (shoulder pain) shows that the pathogenesis of the pain is closely related to the improper passive movement at the early stage of hemiplegia (62.7%). The large range of passive movement is a dangerous factor leading to omalgia. In the study of upper extremity complications, the incidence of shoulder-hand syndrome is relatively high (42.2%), and it is often accompanied by hand swelling (83.1%). The authors suggest that painless movement of the shoulder joint should be limited in a range of 90-120 degrees, massage be carried out immediately after acupuncture, and the affected upper extremity be moved passively during the needle retention. This therapeutic method is definitely effective for pasthemiplegic omalgia.
