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不同手术方式治疗藏毛窦术后初期疼痛评估方法的比较分析。

A Comparative Analysis of Pain Assessment Methods in the Initial Postoperative Phase Following Different Pilonidal Cyst Surgeries.

机构信息

Department of Surgery, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania.

Faculty of Medicine, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania.

出版信息

Medicina (Kaunas). 2024 Oct 18;60(10):1710. doi: 10.3390/medicina60101710.

Abstract

In this study, we aimed to evaluate pain intensity in patients after pilonidal disease surgeries of varying extent using pressure algometry and the visual analog scale and to explore potential correlations between these methods. A total of 78 adult patients with symptomatic pilonidal cysts were enrolled in this study. The patients were divided into two groups based on the type of surgery assigned to each patient at the pre-hospital consultation: pit-picking surgery ( = 39) and radical excision ( = 39). The pain levels at the surgical site were assessed and compared using the visual analog scale (VAS) and pressure algometry the morning before surgery and the day after the operation. There was no statistically significant difference ( > 0.05) in VAS measurement results between surgical groups when comparing pain intensity experienced by patients before, during, and after surgery. Notably, specific pressure algometry variables (pressure pain tolerance left 2.05 ± 1.46 compared to 1.42 ± 0.73 kg/cm, = 0.02; maximum pressure pain tolerance left 2.91 ± 1.33 compared to 2.32 ± 1.14 kg/cm, = 0.04; maximum pressure pain tolerance center 2.51 ± 1.07 compared to 1.91 ± 0.91 kg/cm, = 0.01; interval of pressure pain tolerance center 0.98 ± 0.62 compared to 0.59 ± 0.39 kg/cm, = 0.00) on the first postoperative day were significantly lower in the "pit-picking" group compared to the excision group. Furthermore, no statistically significant correlation was found between VAS and pressure algometry measurements either before surgery or on the first postoperative day. In the early postoperative period following pilonidal disease surgery of varying extents, pain measured with the VAS does not differ. In contrast, the pressure algometry method showed greater pain in the minimally invasive surgery cohort on the first postoperative day. However, further larger studies are needed to compare these pain assessment methods in reporting pain intensity experienced during patient movement.

摘要

在这项研究中,我们旨在使用压力测痛法和视觉模拟评分法评估不同程度的藏毛疾病手术后患者的疼痛强度,并探讨这些方法之间的潜在相关性。共有 78 例有症状的藏毛囊肿成年患者参与了这项研究。根据每位患者在术前咨询时分配的手术类型,将患者分为两组:挑刮术组(n=39)和根治切除术组(n=39)。在手术前一天早上和手术后一天,使用视觉模拟评分法(VAS)和压力测痛法评估并比较手术部位的疼痛程度。在比较手术前后患者的疼痛强度时,手术组之间的 VAS 测量结果无统计学差异(>0.05)。值得注意的是,特定的压力测痛变量(左侧压力疼痛耐受度 2.05±1.46 千克/平方厘米与 1.42±0.73 千克/平方厘米,=0.02;左侧最大压力疼痛耐受度 2.91±1.33 千克/平方厘米与 2.32±1.14 千克/平方厘米,=0.04;中心最大压力疼痛耐受度 2.51±1.07 千克/平方厘米与 1.91±0.91 千克/平方厘米,=0.01;中心压力疼痛耐受度间隔 0.98±0.62 千克/平方厘米与 0.59±0.39 千克/平方厘米,=0.00)在术后第一天显著低于挑刮术组。此外,在术前或术后第一天,VAS 和压力测痛法测量值之间均未发现统计学相关性。在不同程度的藏毛疾病手术后的早期,VAS 测量的疼痛没有差异。相反,在术后第一天,微创外科组的压力测痛法显示出更大的疼痛。然而,需要进一步的更大规模研究来比较这些疼痛评估方法在报告患者活动期间经历的疼痛强度方面的效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b7b/11509449/6d0823b3cc84/medicina-60-01710-g001.jpg

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