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中华结直肠疾病电子杂志 ›› 2020, Vol. 09 ›› Issue (01) : 30 -35. doi: 10.3877/cma.j.issn.2095-3224.2020.01.007

所属专题: 文献

论著

"西京模式"预防性镇痛显著加速结肠癌患者术后康复
郝一鸣1, 季刚1, 冯向英1, 计根林2, 赵青川1,()   
  1. 1. 710032 西安,空军军医大学西京医院消化外科
    2. 710032 西安,空军军医大学西京医院麻醉科
  • 收稿日期:2019-07-01 出版日期:2020-02-20
  • 通信作者: 赵青川
  • 基金资助:
    黎介寿肠道屏障研究项目基金(No.LJS-201704)

The effect of preventive analgesia on the enhanced recovery of colon cancer patients after radical surgery

Yiming Hao1, Gang Ji1, Xiangying Feng1, Genlin Ji2, Qingchuan Zhao1,()   

  1. 1. Department of Gastrointestinal Surgery, Xijing Hospital, Air Force Medical University, Xi′an 710032, China
    2. Department of Anesthesiology, Xijing Hospital, Air Force Medical University, Xi′an 710032, China
  • Received:2019-07-01 Published:2020-02-20
  • Corresponding author: Qingchuan Zhao
引用本文:

郝一鸣, 季刚, 冯向英, 计根林, 赵青川. "西京模式"预防性镇痛显著加速结肠癌患者术后康复[J/OL]. 中华结直肠疾病电子杂志, 2020, 09(01): 30-35.

Yiming Hao, Gang Ji, Xiangying Feng, Genlin Ji, Qingchuan Zhao. The effect of preventive analgesia on the enhanced recovery of colon cancer patients after radical surgery[J/OL]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2020, 09(01): 30-35.

目的

探讨预防性镇痛对结肠癌患者术后康复速度的影响。

方法

采用前瞻性随机对照临床试验方法,纳入81例进行根治性结肠癌切除手术的受试者,随机分配到开腹预防性镇痛组、腹腔镜静脉镇痛泵组、开腹静脉镇痛泵组。结局指标包括患者达到出院标准时间、患者康复指标、疼痛评分、术后并发症发生率。

结果

开腹预防性镇痛组受试者术后达出院标准时间(H=41.054,P<0.05)、术后肛门排气时间(F=15.515,P<0.05)、术后排便时间最短(F=8.003,P<0.05),住院费用最少(F=26.664,P<0.05),术后疼痛VAS评分最低(F=6.727,P<0.05),术后每日离床活动时间最长(F=9.647,P<0.05),三组差异均有统计学意义。三组受试者术后并发症发生率差异无统计学意义(χ2=2.884,P>0.05)。

结论

预防性镇痛能降低患者术后疼痛程度,加速患者术后康复,同时未增加术后并发症。

Objective

To investigate the effect of preventive analgesia on enhanced recovery of patients undergoing colon cancer radical surgery.

Methods

It is a prospective randomized controlled clinical trial. Eighty-one colonic cancer patients who needed for colonic cancer radical surgery were selected prospectively and randomly assigned to preventive analgesia with laparotomy group, patient-controlled intravenous analgesia (PCIA) with laparoscopic group and PCIA with laparotomy group. Study outcomes were the time to meet discharge criteria, patient rehabilitation objectives, pain score, postoperative complication rate.

Results

Preventive analgesia with laparotomy group had the shortest time to meet discharge criteria (H=41.054, P<0.05), the shortest postoperative ventilation time (F=15.515, P<0.05), the shortest postoperative defecation time (F=8.003, P<0.05), the minimum hospitalization cost (F=26.664, P<0.05), the lowest VAS pain score (F=6.727, P<0.05), the longest duration of daily activities out of bed postoperatively (F=9.647, P<0.05). The postoperative complication rates had no statistical significance in the three groups (χ2=2.884, P>0.05).

Conclusions

Preventive analgesia can reduce the postoperative pain and accelerate the patient recovery. Also, it does not increase postoperative complication.

表1 患者一般资料比较(±s
表2 患者手术指标、病理指标比较
表3 患者康复指标(±s
表4 每日离床活动时间(±s,小时)
图1 疼痛VAS评分
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