快速康复外科理论指导下右美托咪啶术后镇痛在腹腔镜胆囊切除术中的应用

发布时间：2018-01-29 01:22

本文关键词： 腹腔镜胆囊切除术快速康复外科术后镇痛右美托咪啶　出处：《山东医药》2016年34期 　论文类型：期刊论文

【摘要】：目的探讨基于快速康复外科(FTS)理论的术后右美托咪啶镇痛在腹腔镜胆囊切除术(LC)中的应用价值。方法将108例行LC患者按照随机数字表法分为两组各54例,FTS组在FTS理论指导下行多模式镇痛且术后给予右美托咪啶镇痛,对照组应用常规围手术期疼痛管理模式。于出手术室时及术后8、24、48 h,采用VAS评估患者术后疼痛程度;比较首次下床活动时间、住院时间及睡眠疼痛程度,记录术后并发症发生情况。结果术后随着时间推移,两组VAS均显著降低,而FTS组出手术室时及术后8、24 h的VAS均低于对照组,P均0.05。与对照组比较,FTS组首次下床活动时间及住院时间显著缩短(P均0.05)。FTS组疼痛未影响睡眠41例、间歇痛醒13例、无法入睡0例,对照组分别为30、22、2例,P均0.05。两组术后切口感染、肺部感染、腹腔感染、下肢静脉血栓的发生率比较,P均0.05;而FTS组并发症的总发生率(9.3%)低于对照组(24.1%),P0.05。结论基于FTS理论指导的LC术后右美托咪啶镇痛可提高疼痛管理效果,减少术后并发症,加速患者的术后康复。
[Abstract]:Objective to investigate the postoperative analgesia of dexmetidine in laparoscopic cholecystectomy (LC) based on the theory of fast rehabilitation surgery (FTS). Methods 108 patients with LC were divided into two groups according to random digital table method. FTS group received multi-mode analgesia under the guidance of FTS theory and received dexmetidine analgesia after operation, while the control group was treated with routine perioperative pain management mode. The degree of postoperative pain was evaluated by VAS. The first time of getting out of bed, the time of hospitalization, the degree of sleep pain and the incidence of postoperative complications were compared. Results with the passage of time, the VAS of the two groups were significantly lower than that of the control group. However, the VAS of FTS group was lower than that of control group (P 0.05) at operating room and 824 h after operation. The first time of getting out of bed and the time of hospitalization were significantly shortened in FTS group. The pain did not affect sleep in 41 cases, intermittent pain in 13 cases, inability to fall asleep in 0 cases, and control group (30 cases). The incidence of incision infection, pulmonary infection, celiac infection and venous thrombosis of lower extremity were 0.05 in both groups. The total incidence of complications in FTS group was lower than that in control group (9. 3% vs 24. 1%). Conclusion Dentomidine analgesia based on FTS theory can improve pain management, reduce postoperative complications and accelerate postoperative recovery.
【作者单位】：上海交通大学医学院附属同仁医院;
【分类号】：R473.6
【正文快照】： 近年来,随着腹腔镜技术的不断完善,腹腔镜胆囊切除术(LC)的安全性与微创意义受到临床普遍认可,已成为非复杂性胆石症治疗的金标准[1]。尽管LC术后疼痛程度较开腹手术明显减轻,但术后24 h内仍有65%以上的患者出现中度疼痛,重度疼痛则占23%[2]。由疼痛所致应激反应可一定程度上

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