疼痛微创介入技术日间手术模式的实践与思考  

PRACTICE AND THINKING OF DAY SURGERY MODE APPLIED TO MINIMALLY INVASIVE INTERVENTION TECHNIQUE FOR PAIN MANAGEMENT

作　　者：李春蕊[1] 王天红 王晶晶 张雯[1] 毛鹏[1] LI Chun-Rui;WANG Tian-Hong;WANG Jing-Jing;ZHANG Wen;MAO Peng(Department of Pain Medicine,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]中日友好医院疼痛科,北京100029

出　　处：《中国疼痛医学杂志》2018年第12期917-920,共4页Chinese Journal of Pain Medicine

摘　　要：目的:比较日间手术与住院手术慢性疼痛病人手术治疗的治疗效果、安全性和病房运行情况。方法:选取细银质针导热术病人122例,随机均分为日间手术组(R组)和住院手术组(Z组)。R组在疼痛门诊完成术前评估后收入日间病房,当日手术,当日出院;Z组在病房完善诊断及术前评估,择期施治,择期出院。两组均采用细银质针导热治疗,分别在术前、术后即刻、1天、1周和4周时评价病人的视觉模拟评分法(visual analogue scale, VAS)评分、SF-36生活质量评分,记录院前等候时间、住院时间、住院费用、病人和医师满意度,记录术中和术后有无并发症。结果:两组病人术前VAS评分和SF-36生活质量评分无明显差异(P> 0.05)。术后即刻、1天、1周和4周时的VAS评分明显低于术前(P <0.05),手术后即刻的SF-36评分与术前无明显差异(P> 0.05),但术后1天、1周和4周的SF-36评分明显高于术前基础值(P <0.05)。R组的院前等候时间、住院时间、住院费用均明显低于,病人和医师满意度均明显高于Z组(P <0.05)。两组均未发生明显手术并发症。结论:疼痛科微创介入技术适合日间手术模式,具有广阔的应用前景。Objective:To compare the efficacy,safety,and ward operation of pain management in day surgery patients and inpatient surgery patients.Methods:One hundred and twenty-two patients undergoing thin silver needle thermal therapy were randomly allocated to either day surgery group(R,n=61)or inpatients group(Z,n=61).For patients of group R,preoperative assessment was completed in the pain clinic,and patients were admitted to the day surgery ward on the surgery day and were discharged after surgery on the same day;For patients of group Z,diagnose,preoperative assessment,operation and discharge were all on schedule in the inpatient ward.Thin silver needle thermal therapy was performed for both groups.The visual analogue scale(VAS)and SF-36 scores were assessed at the time points including pre-surgery,immediately after surgery,1 day,1 week,and 4 weeks after surgery.Patients'prehospital waiting time,hospital stay,hospitalization costs,patients and physicians'satisfaction,and complications,if any,during and after surgery were also recorded.Results:There was no significant difference in VAS and SF-36 scores at pre-surgery between both groups(P>0.05).The VAS scores at time points including immediately after surgery,1 day,1 week and 4 weeks after surgery,were all lower significantly than pre-surgery baseline in both groups(P<0.05).There was no significant difference in SF-36 score at immediately after surgery in both groups.The SF-36 scores at time points including 1 day,1 week,and 4 weeks after surgery were all higher significantly than pre-surgery baseline(P<0.05).Pre-hospital waiting time,hospital stay,and hospitalization costs in group R were considerably lower,and the patients and physicians'satisfaction were significantly higher than those in group Z(P<0.05).No significant complications occurred in both groups.Conclusion:The minimally invasive interventional technique for pain management is suitable for day surgery and has broad application prospects.

关 键 词：日间手术 微创介入 疼痛 手术 

分 类 号：R402[医药卫生—临床医学]