腹腔镜胆囊切除术后肩痛发生的相关因素分析  

ANALYSIS OF CORRELATION FACTORS FOR SHOULDER PAIN AFTER LAPAROSCOPIC CHOLECYSTECTOMY

作　　者：李俊[1] 赵家泉[1] 严明[1] 

机构地区：[1]南京医科大学附属江宁医院普外科,江苏南京211100

出　　处：《牡丹江医学院学报》2012年第5期19-22,共4页Journal of Mudanjiang Medical University

摘　　要：目的:探讨与腹腔镜胆囊切除术后患者肩痛发生可能有关的因素。方法:分析2011-01-01～2011-12-31在南京医科大学附属江宁医院普外科行腹腔镜胆囊切除术的患者,选取术后发生肩痛患者为肩痛组,并随机选取相同时期行腹腔镜胆囊切除术且术后未发生肩痛的患者作为对照组。收集两组患者临床资料并对两组患者进行症状自评量表、汉密尔顿抑郁量表、汉密尔顿焦虑量表评分,应用t检验和卡方检验比较两组间各项临床资料及量表评分的差异。结果:两组患者性别、年龄、高血压病史、糖尿病病史、心率、收缩压、舒张压、血红蛋白、白细胞计数(WBC)、血小板计数(PLT)、空腹血糖、谷丙转氨酶(ALT)、谷草转氨酶(AST)、谷氨酰转肽酶(GGT)、碱性磷酸酶(ALP)、乳酸脱氢酶(LDH)、总胆红素(TBIL)、直接胆红素(DBIL),症状自评量表中人际关系敏感、敌对、恐怖、偏执、精神病性因子评分无统计学差异;肩痛组患者的手术中气腹持续时间明显高于对照组,肩痛组患者症状自评量表躯体化、强迫症状、抑郁、焦虑因子评分和汉密尔顿抑郁量表、汉密尔顿焦虑量表评分明显高于对照组(P<0.05)。结论:腹腔镜胆囊切除术后患者肩痛发生可能与手术中气腹持续时间和患者心理因素有关。Objective：To analyze the correlation risk factors of shoulder pain after Laparoscopic Cholecystectomy.Methods：This analysis is about the patients who had undergone Laparoscopic Cholecystectomy in Department of General Surgery,Jiangning Hospital Affiliated to Nanjing Medical University during Jan 2011 to Dec 2011.19 patients with Shoulder Pain after Laparoscopic Cholecystectomy were selected as Shoulder Pain group,and 30 patients without Shoulder Pain after Laparoscopic Cholecystectomy were randomly selected as control group.Collecting the clinical data of all patients and all the patients were assessed using SCL-90,HAMD,HAMA after operation.Comparison of variables between the two groups was performed using chi-square test and unpaired T-test,respectively.Results： There was no statistical difference between the two groups in respect to Age,Gender,history of Hypertension,history of Diabetesmellitus,Heart Rate,Blood Pressure,Hemoglobin,WBC,PLT,fasting plasma glucose,ALT,AST,GGT,ALP,LDH,TBIL,DBIL and the scores of the Interpersonal Sensitivity、Hostility、Phobic Anxiety、Paranoid Ideation、 Psychoticism factors of SCL-90（P0.05）.However,the duration of pneumoperitoneum,the scores of the Somatization、 Obsessive、Depression、Anxiety factors of SCL-90,the scores of HAMD and the scores of HAMA were significantly higher in the Shoulder Pain group compared with the control group respectively（P0.05）.Conclusion： The duration of pneumoperitoneum and psychological factor play important roles in the shoulder pain after Laparoscopic Cholecystectomy.

关 键 词：腹腔镜胆囊切除术 肩痛 气腹持续时间 心理因素 

分 类 号：R61[医药卫生—外科学]