局部镇痛与基础镇痛对腹腔镜结直肠手术近期疗效影响的随机对照研究  

Effect of local analgesia and basic analgesia on the short-term curative effect of laparoscopic colorectal surgery:a randomized controlled study

作　　者：刘永科[1] 郭栋[1] 金鑫亮 薛清凯 宫之奇 薛伟杰 牛兆建[1] LIU Yong-ke;GUO Dong;JIN Xin-liang(Department of Gastrointestinal Surgery,the Affiliated Hospital of Qingd-ao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院,山东青岛266003

出　　处：《腹腔镜外科杂志》2018年第6期435-439,共5页Journal of Laparoscopic Surgery

摘　　要：目的:分析局部镇痛对腹腔镜结直肠手术患者近期疗效的影响。方法:纳入2017年2月至9月收治的61例结直肠癌患者,随机分为局部镇痛组(n=30)、基础镇痛组(n=31);术后分别予以切口局部镇痛与全身静脉注射镇痛。对比分析两组患者术后疼痛评分、疲劳指数、应激指标及临床恢复情况。结果:局部镇痛组患者术后第1～4天的疼痛评分均低于基础镇痛组(P<0.05),疲劳程度也低于基础镇痛组(P<0.05)。局部镇痛组患者术后第1天促肾上腺皮质激素及术后第3天皮质醇激素水平均低于基础镇痛组(P<0.05)。局部镇痛组首次排气时间、首次排便时间、首次进流食时间均早于基础镇痛组(P<0.05)。两组术后总体并发症发生率差异无统计学意义(P>0.05)。结论:腹腔镜结直肠癌手术患者,切口连续浸润镇痛不仅能减少全身用药的不良反应,而且具有较好的术后镇痛效果,减少了手术应激反应,促进了术后短期恢复,改善了患者的术后生活质量,同时,并未增加术后并发症发生率。Objective：To analyze the effect of local analgesia on short-term clinical effect of laparoscopic colorectal surgery. Methods：Sixty-one patients of eolorectal cancer in the Affiliated Hospital of Qingdao University from Feb. to Sep. 2017 were randomly divided into local analgesia group （n = 30） and basic analgesia group （n = 31 ）. Local analgesia group was given the local analgesia at incision postoperatively, and basic analgesia group was given the intravenous analgesia. The pain score, fatigue index, stress index and clinical recovery of the two groups were observed and compared. Results：The pain scores and fatigue degree from the first day to fourth day after operation in the local analgesia group were lower than those in the basic analgesia group （ P 〈 0.05 ）. The level of eorticotropin level on the first day after operation and the corticosteroid level on the third day after operation in the local analgesia group were lower than those in the basic analgesia group （P 〈 0.05 ）. The first exhaust time, first defecation time, and first liquid diet intake time in the local analgesic group were earlier than those in the basic analgesia group （ P 〈 0.05 ）. There was no significant difference in the inci- dence of postoperative complications between the two groups （ P 〉 0.05 ）. Conclusions ： For patients with laparoscopic colorectal cancer surgery, incision continuous infiltration analgesia not only can reduce systemic drug adverse reactions, but also has better postoperative analgesic effect, reduces the surgical stress response, promotes the short-term recovery of the patients after operation, improves quality of life after surgery, and does not increase the incidence of postoperative complications.

关 键 词：局部镇痛 静脉镇痛 结直肠肿瘤 腹腔镜检查 随机对照试验 

分 类 号：R614[医药卫生—麻醉学]