妇科微创手术围术期疼痛管理的进展

发布时间：2018-11-07 12:38

【摘要】：妇科领域以腔镜为代表的微创手术在临床的应用得到迅速发展,微创手术最大程度的降低了对患者的损伤,若围术期疼痛没有引起足够重视和充分治疗,短期内影响术后恢复,增加并发症发生,远期可引起慢性盆腔痛。因此,加强(术后)围术期疼痛管理,减轻患者痛苦,提高生活质量,与妇科"微创理念"相符合。目前(术后)围术期疼痛管理更注重患者参与,加强专业疼痛管理人员培训,妇科微创术后镇痛模式也由单一的以阿片类药物为主的术后"自控性镇痛"转变为联合用药的超前镇痛或多模式镇痛,患者术后视觉模拟评分(visual analogue scale,VAS)明显降低,且阿片类药物的用量明显减少。根据不同的妇科微创术式个体化选择镇痛模式,将微创理念贯穿于整个医疗行为当中,达到最好的医疗效果。本文对妇科微创手术(术后)围术期疼痛管理的研究进展进行综述,以供参考。
[Abstract]:The clinical application of minimally invasive surgery in gynecology field, represented by endoscopy, has developed rapidly. Minimally invasive surgery minimizes the injury to patients. If perioperative pain does not attract sufficient attention and adequate treatment, it will affect postoperative recovery in the short term. Increased incidence of complications, long-term can cause chronic pelvic pain. Therefore, strengthening perioperative pain management, alleviating the pain of patients and improving the quality of life are in line with the concept of minimally invasive gynecology. At present, perioperative pain management pays more attention to patients' participation and strengthens the training of professional pain management personnel. The mode of postoperative analgesia of gynecological minimally invasive operation also changed from "self-controlled analgesia" with opioid drugs to preemptive analgesia or multi-mode analgesia. The postoperative visual analogue score (visual analogue scale,VAS) of the patients decreased significantly. And the amount of opioid drugs decreased obviously. According to different gynecological minimally invasive operation mode, the concept of minimally invasive analgesia was used in the whole medical behavior to achieve the best medical effect. This article reviews the research progress of perioperative pain management in minimally invasive gynecological surgery (postoperative) for reference.
【作者单位】：首都医科大学附属北京世纪坛医院妇产科;北京大学第一医院妇产科;
【分类号】：R614

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