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随机对照试验:腹腔镜单孔手术(LESS)后使用腹部束带。

A Randomized Controlled Trial for Abdominal Binder Use after Laparoendoscopic Single-Site Surgery.

机构信息

Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas.

Department of Orthopedics, University of Wisconsin-Madison, Madison, Wisconsin.

出版信息

J Minim Invasive Gynecol. 2018 Jul-Aug;25(5):842-847. doi: 10.1016/j.jmig.2017.12.021. Epub 2018 Jan 8.

Abstract

STUDY OBJECTIVE

To compare postoperative pain in patients using an abdominal binder with a control group after laparoendoscopic single-site (LESS) surgery.

DESIGN

A randomized controlled trial (Canadian Task Force classification level 1).

SETTING

An academic gynecologic surgeon's practice.

PATIENTS

Private patients undergoing surgery performed by a fellowship-trained minimally invasive gynecologic surgeon between April 2016 and April 2017.

INTERVENTIONS

Ninety total patients were selected for this study, with 60 randomized to receive an abdominal binder after surgery and 30 patients randomized to the control group without a binder.

MEASUREMENTS AND MAIN RESULTS

Using a 10-point verbal analog scale, patients recorded pain levels for 3 weeks postoperatively on a variety of measures, including overall and incisional pain. They recorded results on postoperative days 0, 1, 2, 3, 4, 7, 14, and 21. On average, the association between time and the overall pain score did not differ with binder use (p = .37). The overall pain decreases significantly over time (p < .001). After adjusting for time, the overall pain score differed significantly by binder status (p = .04). Those without a binder reported an average pain score that was 1.13 (standard deviation = 0.55) points higher than those with a binder across the first week.

CONCLUSION

The results suggest that abdominal binder use after LESS surgery may be beneficial in reducing postoperative pain in the first week. Results from this study can provide feasibility data for future studies.

摘要

研究目的

比较腹腔镜单部位(LESS)手术后使用腹部束带与对照组患者的术后疼痛。

设计

随机对照试验(加拿大任务组分类 1 级)。

设置

学术妇科医生的实践。

患者

2016 年 4 月至 2017 年 4 月期间由接受过微创妇科医生培训的研究员进行手术的私人患者。

干预措施

共有 90 名患者被选入本研究,其中 60 名随机接受手术后腹部束带,30 名患者随机接受无束带的对照组。

测量和主要结果

使用 10 分制的视觉模拟评分法,患者在术后 3 周内记录各种指标的疼痛程度,包括总体疼痛和切口疼痛。他们在术后第 0、1、2、3、4、7、14 和 21 天记录结果。平均而言,与束带使用相关的时间与总体疼痛评分之间没有差异(p = .37)。总体疼痛随时间显著下降(p < .001)。在调整时间后,束带状态对总体疼痛评分有显著差异(p = .04)。未使用束带的患者在第一周的平均疼痛评分比使用束带的患者高 1.13 分(标准差 = 0.55)。

结论

结果表明,LESS 手术后使用腹部束带可能有助于减少术后第一周的疼痛。本研究的结果可为未来的研究提供可行性数据。

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