多学科围术期疼痛干预对胸腔镜肺叶切除术患者术后疼痛、术后恢复和并发症的影响  

Effects of multidisciplinary perioperative pain intervention on postoperative pain,postoperative recovery and complications in patients undergoing thoracoscopic lobectomy

作　　者：葛艳[1] 王丽丽[1] 吐尔逊阿依·买买提 GE Yan;WANG Li-li;TULSONAYI Mai-mai-ti(Department of Anesthesia,the First Affiliated of Xinjiang Medical University,Urumqi 830054,Xinjiang,China)

机构地区：[1]新疆医科大学第一附属医院麻醉科,新疆乌鲁木齐830054

出　　处：《川北医学院学报》2024年第4期565-568,共4页Journal of North Sichuan Medical College

基　　金：新疆维吾尔自治区自然科学基金资助项目(2022D01C753)。

摘　　要：目的:探讨多学科围术期疼痛干预对胸腔镜肺叶切除术(VATS)术后疼痛、术后恢复和并发症的影响。方法:选取施行VATS治疗的116例患者为研究对象。依据干预方式不同将116例VATS患者分为对照组和观察组,每组各58例。对照组实施常规疼痛干预;观察组实施多学科围术期疼痛干预。比较两组疼痛情况[数字疼痛评分法(NRS)]、术后恢复情况、术后康复质量[Quality of Recovery-15,QoR-15]及并发症发生情况。结果:术后24 h及术后72 h观察组静息及咳嗽时NRS评分均低于对照组(P<0.05)。观察组术后首次下床活动时间、首次排气时间、首次经口进食时间及术后住院时间均短于对照组(P<0.05)。术后72 h,两组QoR-15评分均高于术后24 h(P<0.05),且观察组术后24、72 h QoR-15评分均高于对照组(P<0.05)。观察组总并发症发生率低于对照组(8.61%vs.22.41%,P<0.05)。结论:多学科围术期疼痛干预可降低VATS术后疼痛,促进术后恢复进程,提升康复质量,并能在一定程度上减少并发症发生。Objective:To investigate the effects of multidisciplinary perioperative pain intervention on postoperative pain,postoperative recovery and complications in patients undergoing video-assisted thoracic surgery(VATS).Methods:116 patients treated with VATS were selected as the research objects.According to the different intervention methods,the patients were divided into control group(n=58)and observation group(n=58).The control group received routine perioperative pain intervention,and the observation group received multidisciplinary perioperative pain intervention.The pain[numerical pain rating scale(NRS)],postoperative recovery,postoperative quality of recovery[Quality of Recovery-15(QoR-15)]and complications were compared between the two groups.Results:The NRS scores at rest and cough in the observation group were lower than those in the control group at 24 and 72 h after operation(P<0.05).The first time of getting out of bed,the first time of exhaust,the first time of oral feeding and the time of hospitalization after operation in the observation group were shorter than those in the control group(P<0.05).The QoR-15 scores of both groups at 72 h after operation were higher than those at 24 h after operation(P<0.05),and the QoR-15 scores of the observation group at 24 h and 72 h after operation were higher than those of the control group(P<0.05).The incidence of total complications in the observation group was lower than that in the control group(8.61%vs.22.41%,P<0.05).Conclusion:Multidisciplinary perioperative pain intervention can reduce postoperative pain in patients with VATS,promote the postoperative recovery process,improve the quality of rehabilitation,and reduce complications to a certain extent.

关 键 词：胸腔镜肺叶切术 疼痛管理 多学科 康复 并发症 

分 类 号：R473.73[医药卫生—护理学]