消化内镜手术术后疼痛分析:回顾性队列研究

doi:10.6040/j.issn.1671-7554.0.2023.0903

摘要/Abstract

摘要： 目的微创消化内镜手术术后疼痛易被忽视,为优化患者个体化镇痛方案,提高患者的舒适性,回顾分析了不同消化内镜手术术后疼痛程度,为临床工作提供参考。方法回顾性收集1 657例患者资料。采用中文版简明疼痛量表(Chinese Version of the Brief Pain Inventory, BPI-C)进行术后疼痛评估,BPI-C评分大于或等于4表示疼痛控制不佳。采用Logistic回归分析探讨影响术后疼痛的因素。采用广义估计方程(generalized estimating equation, GEE)比较不同手术类型在不同时间点的术后疼痛程度。结果该研究纳入了7种常见的消化内镜手术,大约19.2%的患者BPI-C疼痛评分大于或等于4。GEE分析显示7类手术间术后疼痛存在差异,而且不同时间点术后疼痛强度不同,各类手术患者术后疼痛高峰在术后6 h左右(P<0.001)。12.19%的患者接受了术后镇痛治疗,而仍有31.14%的患者术后渴望使用镇痛药物。结论微创消化内镜手术术后会发生中至重度疼痛,患者对术后镇痛的需求较高,临床医生需提高镇痛意识,优化镇痛方案。

关键词: 消化内镜手术, 术后疼痛, 疼痛评估, 不良反应

Abstract: Objective To analyze the degrees of postoperative pain after different digestive endoscopic surgeries. so as to optimize the analgesia program and improve the comfort of patients. Methods A total of 1,657 patients were surveyed with the Chinese version of the Brief Pain Inventory(BPI-C). BPI-C score ≥4 indicated poor pain control. Factors affecting postoperative pain were evaluated with Logistic regression analysis. The degrees of pain at different time points in different surgeries were analyzed with generalized estimation equation(GEE). Results Altogether 7 common endoscopic surgeries were enrolled. Approximately 19.2% of the patients had BPI-C ≥4. GEE analysis showed that there were differences in postoperative pain among the 7 types of surgeries, and the pain intensity was different at different time points. The peak of postoperative pain occurred approximately 6 h after all kinds of surgeries(P<0.001), and 12.19% of the patients received postoperative analgesia, 31.14% of whom needed further analgesics. Conclusion Moderate to severe pain may occur after minimally invasive digestive endoscopic surgeries, and patients have a high demand for postoperative analgesics. Clinicians need to improve the awareness of analgesia and optimize the analgesia program.

Key words: Digestive endoscopic surgery, Postoperative pain, Pain assessment, Adverse reactions

中图分类号:

R614

武姗姗,汪树仁,赵同航,张宗旺. 消化内镜手术术后疼痛分析:回顾性队列研究[J]. 山东大学学报 (医学版), 2024, 62(2): 42-50.

WU Shanshan, WANG Shuren, ZHAO Tonghang, ZHANG Zongwang. Postoperative pain associated with digestive endoscopic therapies: a retrospective cohort study[J]. Journal of Shandong University (Health Sciences), 2024, 62(2): 42-50.

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