椎管内麻醉改善经尿道输尿管镜激光碎石取石术患者睡眠质量的效果  

Effect of Intraspinal Anesthesia on Sleep Quality in Patients Undergoing Laser Lithotripsy by Transurethral Ureteroscopy

作　　者：张治满 ZHANG Zhiman(Beijing Jingshun Hospital,Beijing 101300,China)

机构地区：[1]北京京顺医院,北京101300

出　　处：《世界睡眠医学杂志》2024年第5期980-982,986,共4页World Journal of Sleep Medicine

摘　　要：目的:评估椎管内麻醉(ITRA)和全身麻醉(GA)对经尿道输尿管镜激光碎石取石术后患者睡眠质量的影响。方法:选取2023年1月至12月北京京顺医院收治的经尿道输尿管镜激光碎石取石术治疗的患者100例作为研究对象,按照患者选择的麻醉方式分为ITRA组(n=75)和GA组(n=25)。收集患者术后匹兹堡睡眠质量指数评分及术后情况;采用Pearson相关系数探究术后睡眠质量评分与术后疼痛评分、术中出血量、年龄的关系。结果:ITRA组术后睡眠质量评分、术后疼痛评分、术后恢复时间、术后并发症发生率低于GA组,差异有统计学意义(P<0.05);术后睡眠质量评分与术后疼痛评分(r=-0.560)、年龄(r=-0.420)、术后恢复时间(r=-0.280)、术后并发症(r=-0.480)负相关,与术中出血量(r=0.340)、手术持续时间(r=0.210)正相关,差异有统计学意义(P<0.05)。结论:本研究表明相对于GA,ITRA可以改善经尿道输尿管镜激光碎石取石术后患者的术后睡眠质量,减轻疼痛感,缩短住院时间。因此建议在临床实践中考虑ITRA作为术前麻醉的首选方法,以提高术后患者的整体生命质量。Objective:The purpose of this paper is to evaluate the effects of intrainal anesthesia(ITRA)and general anesthesia(GA)on postoperative sleep quality in patients after transurethral ureteroscopic laser lithotomy(URS-L).Methods:A total of 100 patients treated by transurethral ureteroscope laser lithotripsia treated in Beijing Jingshun Hospital from January to December 2023 were selected as the study objects,and were divided into ITRA group(n=75)and GA group(n=25)according to the anesthesia method selected by the patients.Pittsburgh sleep quality index score and postoperative status were collected.Pearson correlation coefficient was used to explore the relationship between postoperative sleep quality score and postoperative pain score,intraoperative blood loss and age.Results:Postoperative sleep quality score,postoperative pain score,postoperative recovery time and postoperative complication rate in ITRA group were lower than those in GA group,the difference was statistically significant(P<0.05).Postoperative sleep quality score was negatively correlated with postoperative pain score(r=-0.560),age(r=-0.420),postoperative recovery time(r=-0.280),postoperative complications(r=-0.480),and was positively correlated with intraoperative blood loss(r=0.340)and operative duration(r=0.210),the difference was statistically significant(P<0.05).Conclusion:This study showed that compared with GA,ITRA can improve postoperative sleep quality,relieve pain and shorten hospital stay of patients after transurethral ureteroscopic laser lithotripsy.Therefore,it is recommended to consider ITRA as the preferred method of preoperative anesthesia in clinical practice to improve the overall quality of life of patients after surgery.

关 键 词：尿道结石 椎管内麻醉 全身麻醉 激光碎石取石术 匹兹堡睡眠质量指数 疼痛 相关关系 泌尿系疾病 

分 类 号：R338.63[医药卫生—人体生理学] R983.2[医药卫生—基础医学]