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腹腔镜术后肩部疼痛的危险因素分析

Analysis of risk factors of postlaparoscopic shoulder pain.

作者信息

Wada Shinichiro, Fukushi Yoshiyuki, Nishimura Mai, Matsumoto Sachiko, Takimoto Kanako, Imai Kazuaki, Ota Hajime, Tsuzuki Yoko, Nakajima Ayako, Fujino Takafumi

机构信息

Department of Obstetrics & Gynecology, Teine Keijinkai Hospital, Sapporo, Japan.

出版信息

J Obstet Gynaecol Res. 2020 Feb;46(2):310-313. doi: 10.1111/jog.14156. Epub 2020 Jan 20.

Abstract

AIM

Postlaparoscopic shoulder pain (SP), mainly caused by pneumoperitoneum with CO , sometimes suffers patients. This study was aimed to analyze the backgrounds of SP after gynecologic laparoscopy to clarify the risk of SP.

METHODS

We analyzed answers of questionnaire about the degree of SP from 696 patients undergoing gynecologic laparoscopic surgery since 2014-2018. The questionnaire asks the degree of SP with numeric rating scale from 0 to 10, before and 3 days after operation. We defined cases in which postoperative score elevated more than three compared to preoperative score as SP(+). Analyzed backgrounds were age, parity, body mass index, operative method, operative duration and amount of hemorrhage. Statistics was performed by Fisher exact analysis as univariate analysis, and with logistic regression as multivariate analysis. All laparoscopic surgeries were performed under 10-12 mmHg in pressure of pneumoperitoneum with CO .

RESULTS

Univariate analysis revealed categories 'less than 50 years old', and 'over 2 h' and 'over 3 h' in operative duration resulted significant high rate of SP(+). For these three factors, multivariate analysis resulted that "less than 50 years old' and 'over 3 h in operative duration' were significantly high.

CONCLUSION

This study suggests that 'less than 50 years' old and 'over 3 h in operative duration' were risk factors of postlaparoscopic SP. To protect from SP after laparoscopy, some countermeasures should be necessary especially for these patients.

摘要

目的

腹腔镜术后肩痛(SP)主要由二氧化碳气腹引起,有时会困扰患者。本研究旨在分析妇科腹腔镜术后SP的背景情况,以明确SP的风险。

方法

我们分析了自2014年至2018年接受妇科腹腔镜手术的696例患者关于SP程度的问卷答案。该问卷采用数字评分量表(0至10分)询问患者术前及术后3天的SP程度。我们将术后评分较术前评分升高超过3分的病例定义为SP(+)。分析的背景因素包括年龄、产次、体重指数、手术方式、手术时长和出血量。单因素分析采用Fisher精确检验,多因素分析采用逻辑回归。所有腹腔镜手术均在二氧化碳气腹压力为10至12mmHg的条件下进行。

结果

单因素分析显示,“年龄小于50岁”以及手术时长“超过2小时”和“超过3小时”的患者SP(+)发生率显著较高。对于这三个因素,多因素分析结果表明“年龄小于50岁”和“手术时长超过3小时”的患者SP(+)发生率显著较高。

结论

本研究表明,“年龄小于50岁”和“手术时长超过3小时”是腹腔镜术后SP的危险因素。为预防腹腔镜术后SP,尤其对于这些患者,应采取一些应对措施。

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