首页|阶梯性镇痛在妇科腹腔镜术患者中的应用效果

阶梯性镇痛在妇科腹腔镜术患者中的应用效果

Application Effect of Step Analgesia in Patients Undergoing Gynecological Laparoscopic Surgery

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目的 探讨阶梯性镇痛方案及加速康复外科理念对妇科腹腔镜术患者疼痛、应激反应及胃肠道反应的影响.方法 选取2021年9月至2023年5月在郑州市妇幼保健院行妇科腹腔镜术的280例患者作为研究对象,依据镇痛护理方案分为研究组(阶梯性镇痛方案和加速康复外科理念,120例)和对照组(传统术后镇痛方案和加速康复外科理念,160例).比较两组术后12～48 h的疼痛数字评分(NRS)、5点口头评分法(VRS-5)、Ramasay镇静评分,以及胃肠道反应.结果 NRS、VRS-5评分的时间因素、组间因素、时间因素与组间因素交互作用均有统计学意义(P＜0.05);术后12～48 h研究组的NRS、VRS-5评分低于对照组(P＜0.05).Ramasay镇静评分的时间因素、组间因素、时间因素与组间因素交互作用均有统计学意义(P＜0.05);术后12～48 h研究组的Ramasay镇静评分低于对照组(P＜0.05).研究组恶心、呕吐、瘙痒评分低于对照组(P＜0.05).结论 阶梯性镇痛方案及加速康复外科理念应用于妇科腹腔镜术患者,可有效减轻术后疼痛、应激反应以及胃肠道反应.
Objective To explore the effects of stepwise analgesia and the concept of accelerated rehabilitation surgery on pain,stress response and gastrointestinal response in patients undergoing gynecological laparoscopic surgery.Methods A total of 280 patients who underwent gynecological laparoscopy in Zhengzhou Maternal and Child Health Hospital from September 2021 to May 2023 were selected as the research object.They were divided into a study group(120 cases with a stepwise analgesic plan and an accelerated rehabilitation surgical concept)and a control group(160 cases with a traditional postoperative analgesia program and accelerated rehabilitation surgery concept)based on different analgesic nursing plans.The pain numerical score(NRS),the 5-point verbal rating scale(VRS-5),Ramasay sedation score and gastrointestinal reactions between the two groups at 12-48 hours after surgery were compared.Results The comparison of time factors,inter group factors,time factors and inter group factor interactions in NRS and VRS-5 scores showed statistical significance(P＜0.05).The scores of NRS and VRS-5 in the study group were lower than those in the control group from 12-48 hours after surgery(P＜0.05).The comparison of time factors,inter group factors,time factors and inter group factor interactions in Ramasay sedation score showed statistical significance(P＜0.05).The Ramasay sedation score in the study group was lower than that in the control group at 12-48 hours after surgery(P＜0.05).The scores of nausea,vomiting and itching in the study group were lower than those in the control group(P＜0.05).Conclusion The application of a ladder based analgesic plan and the concept of accelerated rehabilitation surgery in patients undergoing gynecological laparoscopic surgery can effectively alleviate postoperative pain,stress reactions,and gastrointestinal reactions.

stepwise analgesiathe concept of accelerated rehabilitation surgerygynecological laparoscopic surgerypainstress responsegastrointestinal reactions

苗杨、雷伟、张金良、宫宏宇

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郑州市妇幼保健院麻醉科,河南郑州 450000

郑州市妇幼保健院药学部,河南郑州 450000

郑州市第一人民医院麻醉科,河南郑州 450000

郑州市妇幼保健院妇产科,河南郑州 450000

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阶梯性镇痛 加速康复外科理念 妇科腹腔镜术 疼痛 应激反应 胃肠道反应

河南省医学科技攻关计划联合共建项目河南省医学科技攻关计划联合共建项目

LHGJ20220887LHGJ20200741

2024

10.3969/j.issn.1004-437X.2024.07.017

河南医学研究
河南省医学科学院

河南医学研究

影响因子：0.979
ISSN：1004-437X
年,卷(期)：2024.33(7)
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