摘要
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。
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.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2015年第34期2802-2804,共3页
National Medical Journal of China
关键词
生理盐水冲洗
腹腔镜胆囊切除术
负压
引流管
肩痛
Normal saline flush
Laparoscopic cholecystectomy
Negative pressure
Drainage tube
Shoulder pain
