床头高度对经口内镜下食管肌切开术患者术后疼痛的影响分析  

ANALYSIS OF THE CORELATION BETWEEN BED HEAD ANGLE AND POST-POEM PAIN

作　　者：邱晓珏[1] 杨婷[1] 丁伟伟[1] 

机构地区：[1]解放军总医院消化内科,北京市100853

出　　处：《中国煤炭工业医学杂志》2016年第9期1304-1307,共4页Chinese Journal of Coal Industry Medicine

摘　　要：目的探讨床头高度对经口内镜下食管肌切开术患者术后疼痛的影响。方法收集2014年12月—2015年9月于该科成功行POEM术的贲门失弛缓症患者60例,按入院顺序随机分为三组,其中A组为床头抬高0°、B组为床头抬高10°~15°、C组为床头抬高30°~45°。观察各组患者POEM术后第一天、二天、三天疼痛情况,分别给予疼痛评分并记录,统计疼痛频次,应用止痛药物频次。结果三组患者在年龄、性别、疾病史、内镜治疗方式等方面差异无统计学意义（P〉0.05）。三组患者术后第一、二、三天疼痛缓解有效率、疼痛频次、应用止痛药物频次差异有统计学意义（P〈0.05）。结论床头抬高30°~45°能够更好地降低膈肌、减轻对食管的牵拉,从而减少胃食管反流的发生、缓解POEM术后切口疼痛,并减少疼痛发生频次,减少止痛药物应用。Objective To explore the corelation between bed head angle and post-POEM Pain in achalasia patients.Methods Sixty patients,who underwent per-oral endoscopic myotomy（POEM）successfully in auhtor＇s hospital from December 2014 to September 2015,were adopted.They were divided into three groups randomly,with the bed head angle at 0°,10°~15°and30°~45°.The pain circumstances of post-POEM1 d,2d and3 d were observed,and the pain scores,the frequency,times of post-POEM pain and the usage of anodynes were all recorded and compared among these three groups.Results The differences in age,sex,history of disease and POEM procedure were all no statistical significance（P〉0.05）among the three groups.While the remission rates of pain,the frequency and times of post-POEM pain and the usage of anodynes all had significant difference（P〈0.05）.Conclusions The bed head angle at 30°~45°can better lower the positon of the diaphram,which might be beneficial to respiratory motion,reduce the traction to the esophagus and the occurrence of gastroesophageal reflux.The 30°~45°bed head angle can obviously relieve post-POEM pain,reduce the frequency and times of post-POEM pain and the usage of anodynes.

关 键 词：经口内镜下食管肌切开术 床头高度 疼痛评分 

分 类 号：R655.4[医药卫生—外科学]