目的 微创消化内镜手术术后疼痛易被忽视,为优化患者个体化镇痛方案,提高患者的舒适性,回顾分析了不同消化内镜手术术后疼痛程度,为临床工作提供参考.方法 回顾性收集 1 657 例患者资料.采用中文版简明疼痛量表(Chinese Version of the Brief Pain Inventory,BPI-C)进行术后疼痛评估,BPI-C评分大于或等于4 表示疼痛控制不佳.采用Logistic回归分析探讨影响术后疼痛的因素.采用广义估计方程(generalized estimating equa-tion,GEE)比较不同手术类型在不同时间点的术后疼痛程度.结果 该研究纳入了 7 种常见的消化内镜手术,大约19.2%的患者BPI-C疼痛评分大于或等于 4.GEE分析显示 7 类手术间术后疼痛存在差异,而且不同时间点术后疼痛强度不同,各类手术患者术后疼痛高峰在术后6h左右(P<0.001).12.19%的患者接受了术后镇痛治疗,而仍有 31.14%的患者术后渴望使用镇痛药物.结论 微创消化内镜手术术后会发生中至重度疼痛,患者对术后镇痛的需求较高,临床医生需提高镇痛意识,优化镇痛方案.
Postoperative pain associated with digestive endoscopic therapies:a retrospective cohort study
Objective To analyze the degrees of postoperative pain after different digestive endoscopic surgeries.so as to optimize the analgesia program and improve the comfort of patients.Methods A total of 1,657 patients were sur-veyed with the Chinese version of the Brief Pain Inventory(BPI-C).BPI-C score≥4 indicated poor pain control.Factors affecting postoperative pain were evaluated with Logistic regression analysis.The degrees of pain at different time points in different surgeries were analyzed with generalized estimation equation(GEE).Results Altogether 7 common endoscopic surgeries were enrolled.Approximately 19.2%of the patients had BPI-C≥4.GEE analysis showed that there were differences in postoperative pain among the 7 types of surgeries,and the pain intensity was different at different time points.The peak of postoperative pain occurred approximately 6 h after all kinds of surgeries(P<0.001),and 12.19%of the patients received postoperative analgesia,31.14%of whom needed further analgesics.Conclusion Moderate to severe pain may occur after minimally invasive digestive endoscopic surgeries,and patients have a high demand for postoperative analgesics.Clinicians need to improve the awareness of analgesia and optimize the analgesia program.
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