多模式镇痛对小儿隐匿性阴茎矫治术后疼痛的改善效果  

Analysis of the effect of multimodal analgesia on the improvement of postoperative pain after occult penile correction in children

作　　者：张力[1] 黄南翔[1] 王鹏礼 王敏[1] 赵明佳 Zhang Li;Huang Nanxiang;Wang Pengli;Wang Min;Zhao Mingjia(Department of Pediatric Surgery,Nanchong Central Hospital,Second Clinical Medical College of North Sichuan Medical College,Nanchong 637000,China)

机构地区：[1]川北医学院第二临床医学院南充市中心医院小儿外科,南充637000

出　　处：《国际泌尿系统杂志》2024年第2期276-280,共5页International Journal of Urology and Nephrology

基　　金：国家卫生健康委"十三五"规划全国重点课题(YYWS2857);四川省基层卫生事业发展研究中心课题(SWFZ18-C-13)。

摘　　要：目的探讨多模式镇痛对小儿隐匿性阴茎矫治术后疼痛的改善效果。方法选择2020年1月至2021年7月本院接诊的86例小儿隐匿性阴茎患者,按照随机数字表法分为对照组和观察组,每组各43例。对照组采取传统镇痛方案,观察组采取多模式镇痛方案。比较两组患者的生命体征变化情况、疼痛程度、镇静评分、应激激素水平、致痛物质水平及并发症发生情况。结果两组患者用药后的呼吸率、脉搏、动脉压、Wong-Baker面部表情量表得分、Ramsay镇静评分比较,差异均有统计学意义(均P<0.05);两组患者用药后不同时间点的呼吸率、脉搏、动脉压、Wong-Baker面部表情量表得分、Ramsay镇静评分变化趋势比较,差异均有统计学意义(均P<0.05),不同镇痛方法与用药时间有交互作用(均P<0.05)。两组患者用药后的氧分压比较,差异无统计学意义(P>0.05);两组患者用药后不同时间点的氧分压变化趋势比较,差异无统计学意义(P>0.05),不同镇痛方法与用药时间无交互作用(P>0.05)。术后24 h,两组患者的皮质醇、促肾上腺皮质激素、术后24 h两组患者的P物质、五羟色胺水平均高于术前1 h,且对照组均高于观察组(均P<0.05)。观察组共出现5例(11.63%)并发症,观察组出现3例(6.98%)并发症,两组比较差异无统计学意义(P>0.05)。结论多模式镇痛与传统镇痛方案相比,可有效降低小儿隐匿性阴茎矫治术患者的生命体征指标波动,降低疼痛程度及Ramsay镇静评分,并减少应激激素与致痛物质的分泌且不增加并发症发生率。Objective To explore the effect of multimodal analgesia on the pain improvement after occult penile correction in children.Methods From January 2020 to July 2021,86 children with concealed penis admitted in our hospital were selected and randomly divided into two groups,with 43 cases each group.The control group underwent the traditional analgesia plan,and the observation group underwent the multi-modal analgesia plan.The changes in vital signs,pain levels,sedation scores,stress hormone levels,pain-causing substances levels and complications of the two groups were compared.Results The difference in respiratory rate,pulse,mean arterial pressure,Wong-Baker facial expression scale score,Ramsay sedation score between the two groups was statistically significant(all P<0.05).The respiratory rate,pulse,mean arterial pressure,Wong-Baker facial expression scale score,Ramsay sedation score change trends were different in the two groups at different time points after medication(all P<0.05).Different analgesia methods have an interactive effect with the medication time(all P<0.05).There was no significant difference in oxygen partial pressure between the two groups of patients(all P>0.05).The oxygen partial pressure change trend was different at different time points after medication in the two groups(P>0.05).There was no interaction between different analgesia methods and medication time(P>0.05).The levels of cortisol and adrenocorticotropic hormone in the two groups were higher than those in the 1 hour before operation 24 hour after operation,and the control group was higher than the observation group(all P<0.05).The levels of substance P and serotonin in the two groups were higher than 1 hour before operation 24 hour after operation,and the control group was higher than the observation group(all P<0.05).There were 5 cases(11.63%)in the observation group and 3 cases(6.98%)in the observation group.There was no significant difference between the two groups(P>0.05).Conclusions Compared with traditional analgesia,multimodal an

关 键 词：镇痛 矫治手术 隐匿性阴茎 疼痛 

分 类 号：R726.1[医药卫生—儿科]