中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2015年
3期
194-197
,共4页
骆鹏飞%荚卫东%许戈良%马金良%葛勇胜%余继海%乔晓斐
駱鵬飛%莢衛東%許戈良%馬金良%葛勇勝%餘繼海%喬曉斐
락붕비%협위동%허과량%마금량%갈용성%여계해%교효비
肝切除术%疼痛,手术后
肝切除術%疼痛,手術後
간절제술%동통,수술후
Hepatectomy%Pain,postoperative
目的 探讨肝切除术后疼痛的发生情况及其影响因素.方法 回顾性分析555例行肝切除术患者的临床资料及术后疼痛发生情况,使用单因素分析及Logistic回归分析术后疼痛的相关影响因素.结果 本组555例行肝切除术的患者中,255例出现术后中重度疼痛,术后中重度疼痛发生率为45.95%.其中以切口疼痛最常见,性质以刀割样痛最多,原因以手术创伤为主,其次为术后并发症引起的疼痛.按是否发生术后疼痛分为术后疼痛组(n =255)和非术后疼痛组(n =300),单因素分析显示2组差异有统计学意义的因素有年龄(t =3.435,P<0.01)、手术史(x2=26.190,P<0.01)、手术方式(x2=31.336,P <0.01)、切口长度(t=8.328,P<0.01)、切除剑突(x2=19.423,P<0.01)、切口最终结局(x2=311.535,P<0.01)、并发症(x2=126.937,P<0.01).Logistic回归分析结果显示手术史(P =0.001)、手术方式(P =0.005)、切口长度(P =0.000)、切除剑突(P =0.001)、并发症(P =0.000)为术后疼痛的独立影响因素.结论 肝切除术后疼痛与既往手术史、手术方式、切口长度、是否切除剑突以及术后是否发生并发症有关.
目的 探討肝切除術後疼痛的髮生情況及其影響因素.方法 迴顧性分析555例行肝切除術患者的臨床資料及術後疼痛髮生情況,使用單因素分析及Logistic迴歸分析術後疼痛的相關影響因素.結果 本組555例行肝切除術的患者中,255例齣現術後中重度疼痛,術後中重度疼痛髮生率為45.95%.其中以切口疼痛最常見,性質以刀割樣痛最多,原因以手術創傷為主,其次為術後併髮癥引起的疼痛.按是否髮生術後疼痛分為術後疼痛組(n =255)和非術後疼痛組(n =300),單因素分析顯示2組差異有統計學意義的因素有年齡(t =3.435,P<0.01)、手術史(x2=26.190,P<0.01)、手術方式(x2=31.336,P <0.01)、切口長度(t=8.328,P<0.01)、切除劍突(x2=19.423,P<0.01)、切口最終結跼(x2=311.535,P<0.01)、併髮癥(x2=126.937,P<0.01).Logistic迴歸分析結果顯示手術史(P =0.001)、手術方式(P =0.005)、切口長度(P =0.000)、切除劍突(P =0.001)、併髮癥(P =0.000)為術後疼痛的獨立影響因素.結論 肝切除術後疼痛與既往手術史、手術方式、切口長度、是否切除劍突以及術後是否髮生併髮癥有關.
목적 탐토간절제술후동통적발생정황급기영향인소.방법 회고성분석555례행간절제술환자적림상자료급술후동통발생정황,사용단인소분석급Logistic회귀분석술후동통적상관영향인소.결과 본조555례행간절제술적환자중,255례출현술후중중도동통,술후중중도동통발생솔위45.95%.기중이절구동통최상견,성질이도할양통최다,원인이수술창상위주,기차위술후병발증인기적동통.안시부발생술후동통분위술후동통조(n =255)화비술후동통조(n =300),단인소분석현시2조차이유통계학의의적인소유년령(t =3.435,P<0.01)、수술사(x2=26.190,P<0.01)、수술방식(x2=31.336,P <0.01)、절구장도(t=8.328,P<0.01)、절제검돌(x2=19.423,P<0.01)、절구최종결국(x2=311.535,P<0.01)、병발증(x2=126.937,P<0.01).Logistic회귀분석결과현시수술사(P =0.001)、수술방식(P =0.005)、절구장도(P =0.000)、절제검돌(P =0.001)、병발증(P =0.000)위술후동통적독립영향인소.결론 간절제술후동통여기왕수술사、수술방식、절구장도、시부절제검돌이급술후시부발생병발증유관.
Objective To investigate the occurrence of postoperative pain of hepatectomy and its possible related factors.Methods The clinical data of 555 cases undergoing hepatectomy was analyzed retrospectively,and the related influencing factors on postoperative pain of hepatectomy were analyzed by univariate analysis and multivariate logistic regression.Results Moderate postoperative pain was reported in 255 cases among 555 patients who underwent hepatic resection (with an incidence of 45.95%).Incision pain which was often sharp was most common,followed by postoperative complication caused pain.According to whether the postoperative pain occurred or not,all cases were divided into postoperative pain group (n =255) and non-postoperative pain group (n =300),univariate analysis showed that age (P <0.01),surgical history (P < 0.01),surgical approach (P < 0.01),incision length (P < 0.01),xiphoid removal(P < 0.01),the final outcome of incision (P < 0.01),complications (P < 0.01) were significantly different between the two groups.Logistic multiple regression analysis showed that the independent influencing factors of postoperative pain included surgical history (P =0.001),surgical approach (P =0.005),incision length (P =0.000),xiphoid process removal (P =0.001),complications (P =0.000).Conclusions The postoperative pain of hepatectomy has a high incidence.Surgical history,surgical approach,incision length,xiphoid process,removal and postoperative complications are the independent impact factors of postoperative pain.