虚拟现实技术在腹膜透析相关手术术中疼痛管理的应用初探  

Preliminary application of virtual reality for pain management in patients undergoing peritoneal dialysis-related procedures

作　　者：陈思秀 李剑波[1] 余健文 周玉君 李幼奇[2] 林小洁 黄娜娅 钟忠 王禹诺 黎渐英[1] 刘庆华[1] 毛海萍[1] 黄锋先[1] 陈崴[1] Chen Sixiu;Li Jianbo;Yu Jianwen;Zhou Yujun;Li Youqi;Lin Xiaojie;Huang Naya;Zhong Zhong;Wang Yunuo;Li Jianying;Liu Qinghua;Mao Haiping;Huang Fengxian;Chen Wei(Department of Nephrology,the First Affiliated Hospital of Sun Yat-sen University,NHC Key Laboratory of Nephrology,Guangdong Provincial Key Laboratory of Nephrology,Guangzhou 510080,China;Department of Nephrology,Huizhou Central People's Hospital,Huizhou 516000,China;Department of Nephrology,Guangdong Second People's Hospital,Guangzhou 510320,China)

机构地区：[1]中山大学附属第一医院肾内科,卫生健康委肾脏病重点实验室,广东省肾脏病重点实验室,广州510080 [2]惠州市中心人民医院肾内科,惠州516000 [3]广东省第二人民医院肾内科,广州510320

出　　处：《中华肾脏病杂志》2024年第7期520-525,共6页Chinese Journal of Nephrology

基　　金：国家自然科学基金(81970599,82170737,82370707)。

摘　　要：目的初步探索虚拟现实(virtual reality,VR)技术在接受腹膜透析(peritoneal dialysis,PD)相关手术并进行局部浸润麻醉患者术中疼痛管理的应用及患者满意度。方法本研究为单中心、前瞻性同期对照研究,患者分为VR组与对照组,VR组在手术过程中佩戴VR眼镜观看舒缓的音视频,对照组为常规手术流程。术后30 min内通过视觉模拟量表(visual analogue scale,VAS)和5分制满意度量表评估患者术中疼痛和满意度,VR组使用VR晕动量表评估耐受情况。结果研究共纳入43例患者,其中男性25例(58.1%)。原发病主要为慢性肾小球肾炎[17例(39.5%)]和糖尿病肾病[6例(14.0%)]。对照组23例,VR组20例,两组在年龄、性别比例、原发病比例,合并糖尿病、高血压病,手术方式分布、术前生命体征和手术时间等方面的差异均无统计学意义(均P>0.05);VR组VAS疼痛评分显著低于对照组[(5.90±2.38)分比(7.43±1.67)分,t=2.469,P=0.018]。VR组满意及以上患者的比例为89.5%(17/19),对照组满意及以上患者比例为78.3%(18/23),但两组差异无统计学意义(连续性校正χ^(2)检验,χ^(2)=0.308,P=0.579)。VR组3例患者因严重不适退出,其余均可耐受,常见不良反应为疲劳和视力模糊。结论VR可有效减轻局部浸润麻醉下PD相关手术的术中疼痛,且在PD相关手术过程中佩戴VR眼镜是安全、可耐受的。Objective To investigate the application of virtual reality(VR)technology on intraoperative pain in patients undergoing peritoneal dialysis(PD)-related procedures with local infiltration anesthesia and the satisfaction.Methods It was a single-center,prospective,concurrent controlled study.Patients were divided into two groups:VR group and control group.In the VR group,patients wore a VR headset to watch soothing audio and video content during surgery,while the control group underwent routine procedures.Intraoperative pain and satisfaction were assessed using the visual analog scale(VAS)and a 5-point satisfaction scale within 30 minutes of surgery.In addition,tolerance of the VR experience in the VR group was assessed using the VR sickness questionnaire.Results A total of 43 patients were included in the study,including 25 males(58.1%).Chronic glomerulonephritis[17 cases(39.5%)]and diabetic nephropathy[6 cases(14.0%)]were the main primary diseases.There were 23 cases in the control group and 20 cases in the VR group.There were no significant differences between the two groups in age,sex ratio,proportion of primary disease,diabetes,hypertension,distribution of operation methods,preoperative vital signs and operation time(all P>0.05).VAS pain score was significantly lower in the VR group than that in the control group(5.90±2.38 vs.7.43±1.67,t=2.469,P=0.018).The percentage of patients who were satisfied was 89.5%(17/19)in the VR group and 78.3%(18/23)in the control group,but there was no significant difference(chi-square test for continuity correction,χ²=0.308,P=0.579).Three patients in the VR group withdrew from the study due to severe discomfort,while the remaining participants found the VR experience to be tolerable.Common adverse effects included fatigue and blurred vision.Conclusions The application of VR technology in PD-related procedures has been effective in reducing intraoperative pain when combined with local infiltration anesthesia.Furthermore,the utilization of VR technology in PD-related procedures

关 键 词：虚拟现实 腹膜透析 疼痛 患者满意度 

分 类 号：R692[医药卫生—泌尿科学]