腹腔镜下肾切除术后急性疼痛的危险因素研究  

Risk factors for acute pain after laparoscopic nephrectomy

作　　者：王军 黄枭 魏昌伟 Wang Jun;Huang Xiao;Wei Changwei(Department of Anesthesiology,Peking University International Hospital,Beijing 102206,China;Department of Anesthesiology,Beijing Chao-yang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]北京大学国际医院麻醉科,北京102206 [2]首都医科大学附属北京朝阳医院麻醉科,北京100020

出　　处：《中国医药》2022年第7期1039-1042,共4页China Medicine

摘　　要：目的探讨腹腔镜下肾切除术后急性疼痛的危险因素。方法本研究为回顾性队列研究,选取2020年6月至2021年6月在首都医科大学附属北京朝阳医院接受腹腔镜下单侧肾切除术的住院患者85例,根据术后24 h视觉模拟量表(VAS)评分将患者分为疼痛组(32例,≥4分)和非疼痛组(53例,<4分)。记录患者围术期相关资料,采用多因素Logistic回归方程分析术后急性疼痛的危险因素。结果疼痛组术前失眠严重程度指数量表(ISI)、广泛性焦虑量表7(GAD-7)评分均高于非疼痛组[(8.7±1.7)分比(4.1±0.8)分、(8.3±2.4)分比(3.6±0.5)分],手术时间长于非疼痛组,术中瑞芬太尼用量、术后氟比洛芬酯用量及术前VAS评分均高于非疼痛组,差异均有统计学意义(均P<0.05)。多因素Logistics回归分析结果显示,术前高ISI评分、术前高GAD-7评分、手术时间长和术前高VAS评分是行腹腔镜下肾切除术患者术后急性疼痛的独立危险因素(均P<0.05)。结论术前疼痛、焦虑、睡眠质量差及手术时间长是腹腔镜下肾切除患者术后急性疼痛的危险因素。Objective To investigate risk factors for acute pain after laparoscopic nephrectomy.Methods This was a retrospective cohort study.From June 2020 to June 2021,85 patients undergoing laparoscopic unilateral nephrectomy in Beijing Chao-yang Hospital,Capital Medical University were enrolled.According to visual analogue scale(VAS)score 24 h after surgery,patients were divided into the pain group(32 cases,≥4)and the non-pain group(53 cases,<4).Data of patients were recorded between and after operation,and multivariate Logistic regression analysis was used to analyze risk factors for acute postoperative pain.Results Scores of insomnia severity index scale(ISI)and generalized anxiety disorder-7(GAD-7)before operation in the pain group were higher than those in the non-pain group[(8.7±1.7)vs(4.1±0.8),(8.3±2.4)vs(3.6±0.5)],operative duration was longer than that in the non-pain group,and intraoperative dosage of remifentanil,postoperative dosage of flurbiprofen and preoperative VAS score were higher than those in the non-pain group(all P<0.05).Multivariate Logistic regression analysis showed that high preoperative ISI score,high preoperative GAD-7 score,long operative duration and high preoperative VAS score were independent risk factors for acute pain after laparoscopic nephrectomy(all P<0.05).Conclusion Pain,anxiety and poor sleep quality before operation and long operative duration are independent risk factors for acute pain after laparoscopic nephrectomy.

关 键 词：腹腔镜下肾切除术 术后疼痛 危险因素 

分 类 号：R619[医药卫生—外科学]