摘要
目的探讨基于快速康复外科理念的多模式镇痛在混合痔手术中的应用及临床效果。方法选取2019年1~6月我院收治的60例拟行混合痔外剥内扎术的混合痔患者作为研究对象。根据入院顺序将患者分为观察组和对照组,每组各30例。在围术期,观察组患者施行基于快速康复外科理念的多模式镇痛,对照组患者按传统模式镇痛。观察两组患者的视觉模拟量表(VAS)评分、术后首次排便时间、首次下床活动时间和术后住院时间;比较两组患者术后48 h内的嗜睡、尿潴留、恶心呕吐、皮肤瘙痒及呼吸抑制等不良反应发生情况。结果观察组患者术后不同时间点(术后即刻、术后第4、12、24及48小时)的VAS评分均低于对照组,差异有统计学意义(P<0.05);观察组患者的术后首次排便时间及首次下床时间均早于对照组,差异有统计学意义(P<0.05);两组患者术后48 h内的嗜睡、恶心呕吐、尿潴留、呼吸抑制、皮肤瘙痒发生率比较,差异均无统计学意义(P>0.05)。结论在混合痔患者围术期中,应用基于快速康复外科理念的多模式镇痛,能够明显减轻患者的疼痛,镇痛效果好,利于患者术后康复,并未增加不良反应的发生率。
Objective To explore the application and clinical effect of multimodal analgesia based on the concept of rapid rehabilitation surgery in mixed hemorrhoid surgery.Methods From January to June 2019,60 patients with mixed hemorrhoids admitted to our hospital to undergo milligan-morgan hemorrhodectomy were selected as the research objects.They were divided into observation group and control group according to the order of admission,with 30 cases in each group.During the perioperative period,patients in the observation group were subjected to multimodal analgesia based on the concept of rapid rehabilitation surgery,while patients in the control group were subjected to traditional mode analgesia.Visual analogue scale(VAS)score,postoperative first defecation time,postoperative first ambulation time and postoperative hospital stay time were observed between the two groups.The occurrence of adverse reactions such as drowsiness,urinary retention,nausea and vomiting,itchy skin and respiratory depression within 48 h after operation were compared between the two groups.Results The VAS scores of the observation group at different postoperative time points(immediately after surgery,at the 4th,12th,24th and 48th hour after surgery)were lower than those of the control group,and the differences were statistically significant(P<0.05).The first defecation time and the first time to get out of bed after the observation group were earlier than the control group,and the differences were statistically significant(P<0.05).The incidence rates of drowsiness,nausea and vomiting,urinary retention,respiratory depression and skin pruritus between the two groups within 48 h after surgery were not statistically significant(P>0.05).Conclusion The concept of rapid rehabilitation surgery in the perioperative application of patients with mixed hemorrhoids can significantly reduce the patients′pain,has a good analgesic effect,facilitates the patients′postoperative recovery,and does not increase the incidence of adverse reactions.
作者
向广阳
欧昌柏
张晓威
周运添
XIANG Guang-yang;OU Chang-bai;ZHANG Xiao-wei;ZHOU Yun-tian(Department of General Surgery,People′s Hospital of Huidong County in Huizhou City,Guangdong Province,Huidong516300,China)
出处
《中国当代医药》
2020年第19期108-111,共4页
China Modern Medicine
基金
广东省惠州市科技计划(2019Y329)。
关键词
混合痔
快速康复外科
多模式镇痛
外剥内扎术
视觉模拟量表评分
Mixed hemorrhoid
Rapid rehabilitation surgery
Multimodal analgesia
Milligan-morgan hemorrhodectomy
Visual analogue scale score
