中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2015年
34期
2802-2804
,共3页
张涛%王磬%吴微庆%施海华
張濤%王磬%吳微慶%施海華
장도%왕경%오미경%시해화
生理盐水冲洗%腹腔镜胆囊切除术%负压%引流管%肩痛
生理鹽水遲洗%腹腔鏡膽囊切除術%負壓%引流管%肩痛
생리염수충세%복강경담낭절제술%부압%인류관%견통
Normal saline flush%Laparoscopic cholecystectomy%Negative pressure%Drainage tube%Shoulder pain
目的 观察改善腹腔镜胆囊切除术(LC)后肩部疼痛发生的防治方法.方法 将99例行LC的患者随机分为A、B、C组,每组33例.A组为对照组,B组为术后右膈下留置负压引流管2h,C组术中右膈下温热生理盐水冲洗,观察3组术后1、3、6、12、24、48、72 h肩痛的发生率和疼痛程度视觉模拟评分(VAS).结果 72 h内出现肩痛B组(6例)、C组(1例)肩痛发生率明显低于A组(14例),而C组处理方式对改善肩痛效果最明显,组间比较差异有统计学意义(x2=2.733,P=0.004),而且B组(术后24h为1.02±0.27、48 h为0.72±0.26)、C组术后(24 h为0.15±0.02、48 h为0.08±0.21)肩痛程度VAS均低于A组(术后24 h为2.25±1.23、48 h为2.09±0.74),C组程度最轻(P＜0.05).结论 温热生理盐水右膈下冲洗,可能阻断了引起肩痛的多种机制,明显降低了肩痛的发生,值得临床上推广.
目的 觀察改善腹腔鏡膽囊切除術(LC)後肩部疼痛髮生的防治方法.方法 將99例行LC的患者隨機分為A、B、C組,每組33例.A組為對照組,B組為術後右膈下留置負壓引流管2h,C組術中右膈下溫熱生理鹽水遲洗,觀察3組術後1、3、6、12、24、48、72 h肩痛的髮生率和疼痛程度視覺模擬評分(VAS).結果 72 h內齣現肩痛B組(6例)、C組(1例)肩痛髮生率明顯低于A組(14例),而C組處理方式對改善肩痛效果最明顯,組間比較差異有統計學意義(x2=2.733,P=0.004),而且B組(術後24h為1.02±0.27、48 h為0.72±0.26)、C組術後(24 h為0.15±0.02、48 h為0.08±0.21)肩痛程度VAS均低于A組(術後24 h為2.25±1.23、48 h為2.09±0.74),C組程度最輕(P＜0.05).結論 溫熱生理鹽水右膈下遲洗,可能阻斷瞭引起肩痛的多種機製,明顯降低瞭肩痛的髮生,值得臨床上推廣.
목적 관찰개선복강경담낭절제술(LC)후견부동통발생적방치방법.방법 장99례행LC적환자수궤분위A、B、C조,매조33례.A조위대조조,B조위술후우격하류치부압인류관2h,C조술중우격하온열생리염수충세,관찰3조술후1、3、6、12、24、48、72 h견통적발생솔화동통정도시각모의평분(VAS).결과 72 h내출현견통B조(6례)、C조(1례)견통발생솔명현저우A조(14례),이C조처리방식대개선견통효과최명현,조간비교차이유통계학의의(x2=2.733,P=0.004),이차B조(술후24h위1.02±0.27、48 h위0.72±0.26)、C조술후(24 h위0.15±0.02、48 h위0.08±0.21)견통정도VAS균저우A조(술후24 h위2.25±1.23、48 h위2.09±0.74),C조정도최경(P＜0.05).결론 온열생리염수우격하충세,가능조단료인기견통적다충궤제,명현강저료견통적발생,치득림상상추엄.
Objective To investigate the effect of two methods on postoperative shoulder pain following laparoscopic cholecystectomy (LC).Methods A total of 99 patients undergoing LC were prospectively divided into three groups (33 patients in each group):Patients in group A underwent LC were control group,those in group B were inserted negative pressure drainage tube under the right inferior phrenic after LC,and patients in group C accepted warm and normal saline flush during operation under the right inferior phrenic.Shoulder pain occurrence and shoulder pain levels (visual analogue pain scale-VAS) were recorded on 1,3,6,24,48,72 h after operation.Results Postoperative shoulder pain occurrence was significantly higher in group A (14/33) than those in group B (6/33) and group C (1/33),and group C had the best effect (x2 =2.733,P =0.004) among the 3 groups.For shoulder pain levels,same result was achieved with group C had the best effect (P ＜ 0.05).Conclusion Warm and normal saline flush during operation under the right inferior phrenic could help to obviously reduce the occurrence of post LC shoulder pain probably by blocking some mechanisms causing postoperative shoulder pain after LC.
