成人腹部手术后镇痛的最新进展  

Recent Advances in Analgesia after Abdominal Surgery in Adults

作　　者：龚德慧 张盼 张愫艺 马文慧 王思 

机构地区：[1]延安大学附属医院麻醉科,陕西 延安

出　　处：《临床医学进展》2024年第10期260-266,共7页Advances in Clinical Medicine

摘　　要：腹部手术是外科领域中常见的手术类型。由于其较大的创伤、炎症反应、粘膜缺血缺氧以及内脏和腹膜的牵拉等因素,术后不可避免地会产生切口痛、内脏痛和创伤应激反应。这些剧烈的疼痛会影响患者的术后翻身、深呼吸、咳痰等动作,从而增加术后肺不张、肺部感染等并发症的风险。此外,急性疼痛还容易引发患者的焦虑、紧张等负面情绪,导致免疫紊乱和应激状态,甚至可能影响手术切口的愈合。研究指出,术后剧烈的急性疼痛是术后慢性疼痛的高风险因素,因此术后镇痛显得尤为重要。加速康复外科理念强调多模式镇痛的重要性,本文将就成人腹部手术术后镇痛的最新进展进行综述。Abdominal surgery is a common surgical operation in clinical practice. Due to factors such as greater trauma, inflammation, mucosal ischemia and hypoxia, as well as visceral and peritoneal pull, abdominal surgery will inevitably produce incision pain, visceral pain and traumatic stress reaction after surgery. Severe pain will affect patients’ postoperative movements such as turning over, deep breathing and expectoration. It increases the risk of postoperative complications such as atelectasis and pulmonary infection. In addition, acute pain can easily lead to patients’ anxiety, tension and other negative emotions, resulting in immunosuppression and stress, and even affecting the healing of surgical incisions. Studies have shown that acute postoperative pain is a high risk factor for chronic postoperative pain, so postoperative analgesia is particularly important. The concept of accelerated rehabilitation surgery also suggests that multi-modal analgesia is an important link. This article reviews the progress of postoperative analgesia in adult abdominal surgery.

关 键 词：腹部手术 术后镇痛 超声引导下神经阻滞 

分 类 号：R65[医药卫生—外科学]