不同术式冠状动脉旁路移植术后早期疼痛发生率及其相关因素  

Incidence and risk factors of post-operative pain after coronary artery bypass with different operation procedure

作　　者：周红[1] 张赤铭[1] 杨晓婷[1] 徐文红[1] 赵彦珍[1] 

机构地区：[1]解放军总医院心血管外科,北京100853

出　　处：《中华现代护理杂志》2012年第11期1272-1274,共3页Chinese Journal of Modern Nursing

摘　　要：目的对比分析全机器人冠状动脉旁路移植术（BH—TECAB）和非体外循环冠状动脉旁路移植术（OPCAB）术后早期（术后1周内）患者疼痛的发生率及其可能的影响因素。方法选取冠状动脉旁路移植术后患者80例，根据术式不同分为2组：BH-TECAB组（40例）和OPCAB组（40例）。记录两组患者基本情况、术前疼痛情况、麻醉情况、手术及术后情况，并根据简明疼痛问卷对患者手术后早期疼痛情况进行记录。结果80例患者一般情况无差异（P〉0．05），均由同一术者完成，手术顺利，无并发症，均痊愈出院。BH—TECAB组中患者术后早期的1级、2级、3级疼痛发生率分别为32．5％（13／40）、7．5％（3／40）和2．5％（1／40），而OPCAB组的发生率分别为45．0％（18／40）、15．0％（6／40）和10．0％（4／40），两组相比差异有统计学意义（P〈0．05）。结论手术方式的不同是BH—TECAB和OPCAB患者术后早期疼痛发生率不同的直接影响因素。与OPCAB相比，BH—TECAB具有创伤小、痛苦小、切121美观及愈合快的特点。Objeetlve To study the incidence and risk factors of post-operative pain after receive offpump coronary artery bypass grafting （ OPCAB ） and totally endoscopic coronary artery bypass graft on beating heart（BH-TECAB）. Methods Totals of 80 patients received coronary artery bypass grafting were divided into two groups according to the different of operation procedure, BH-TECAB group （40 cases）and OPCAB group （40 cases）. Basic situation, anesthesia conditions, surgical conditions, postoperative situation, and the incidence and degree of postoperative pain in two groups were collected. Results There was no significant difference between two groups in the basic situation. All patients had no postoperative complications and recovered smoothly. The incidence of 1-degree, 2-degree and 3-degree postoperative pain in the BH-TECAB group [32.5% （13/40）, 7.5% （3/40） and 2.5% （1/40）] was significantly lower than that in the OPCAB group [ 45.0% （ 18/40）, 15.0% （6/40） and 10.0% （4/40） 1, the difference was significant （ P 〈 0.05 ）. The time of breathing machine using, blood transfusion in 24 hours, the amount of flow in BH-TECAB group, respectively,was（14.35 ±1.66） h, （54.79 ±15.69） ml, （227.12 ± 120.38） ml,that significantly lower than that in OPCAB group which was （ 18.64± 1.57） h, （ 120.75 ± 20.98 ） ml and （ 389. 17 ±138.66 ） ml, the difference was significant （ P 〈 0.05 ）. Conclusions The different of the operation procedure influences the incidence of postoperative pain of patients receive coronary artery bypass grafting. BH-TECAB has the features of mini-wound, less pain and fast healing.

关 键 词：疼痛 机器人 冠状动脉旁路移植术 

分 类 号：R654.2[医药卫生—外科学]