Jorgensen J O, Gillies R B, Hunt D R, Caplehorn J R, Lumley T
Laparoscopic Research Unit, St. George Hospital, Sydney, New South Wales, Australia.
Aust N Z J Surg. 1995 Jul;65(7):466-9. doi: 10.1111/j.1445-2197.1995.tb01787.x.
The aims of this study were to see if laparoscopic cholecystectomy is associated with a similar postoperative pain pattern to gynaecological laparoscopy and to see whether the use of a suprahepatic suction drain makes recovery from laparoscopic cholecystectomy more comfortable. After routine laparoscopic cholecystectomy and insertion of a suprahepatic suction drain, patients were randomized to suction or no suction on the drain. The time course of the severity of wound, abdominal and shoulder tip pain was assessed by visual analogue scales administered in the morning and afternoon of the first 3 postoperative days. The control group had a high incidence of shoulder tip pain similar to that after gynaecological laparoscopy. Patients in the treatment group reported significantly less shoulder tip pain than the control group (O.R. 0.16, 95% CI, 0.06-0.40). There was a tendency for the treatment group to report reduced abdominal and, to a lesser extent, wound pain. The authors recommend suprahepatic suction as a simple and more effective way to improve patient comfort after laparoscopic cholecystectomy.
本研究的目的是观察腹腔镜胆囊切除术术后疼痛模式是否与妇科腹腔镜手术相似,以及观察使用肝上吸引引流管是否能使腹腔镜胆囊切除术后的恢复更舒适。在进行常规腹腔镜胆囊切除术并插入肝上吸引引流管后,患者被随机分为引流管吸引组和非吸引组。通过在前3个术后日的上午和下午使用视觉模拟量表评估伤口、腹部和肩峰疼痛严重程度的时间进程。对照组肩峰疼痛的发生率较高,与妇科腹腔镜手术后相似。治疗组患者报告的肩峰疼痛明显少于对照组(比值比0.16,95%可信区间,0.06 - 0.40)。治疗组有腹部疼痛减轻的趋势,伤口疼痛减轻程度较小。作者推荐肝上吸引作为一种简单且更有效的方法来提高腹腔镜胆囊切除术后患者的舒适度。