Ellström M, Olsén M F, Olsson J H, Nordberg G, Bengtsson A, Hahlin M
Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Göteborg, Sweden.
Acta Obstet Gynecol Scand. 1998 Oct;77(9):923-8.
The aim of this study was to evaluate pain and pulmonary function the first two days after abdominal and laparoscopic hysterectomy.
Women scheduled for abdominal hysterectomy were prospectively randomized to either laparoscopic (n=20) or abdominal (n=20) hysterectomy. Analgesics were self-administered by the patients by means of a programable infusion pump containing morphine. Postoperative pain was evaluated using a visual analog scale. Oxygen saturation was measured with an oxymeter. Pulmonary function was assessed using a peak flow meter measuring peak expiratory flow and a vitalograph measuring forced vital capacity and forced expiratory volume in one second.
Pain scores were lower after laparoscopic hysterectomy at the first (p<0.05) and second postoperative day (p<0.01). Lung function was impaired on days 1 and 2 postoperatively, measured as peak expiratory flow, forced vital capacity and forced expiratory volume in one second, in both groups compared to the preoperative values. The patients undergoing laparoscopic hysterectomy had less impairment of lung function measured by peak expiratory flow (p<0.01), forced vital capacity (p<0.05) and forced expiratory volume in one second (p<0.05) the first postoperative day compared to the patients undergoing abdominal hysterectomy. The second postoperative day differences between the groups remained for peak expiratory flow (p<0.05) and forced expiratory volume in one second (p<0.05).
Laparoscopic hysterectomy results in less pain and less impairment of respiratory function compared to abdominal hysterectomy.
本研究旨在评估腹式子宫切除术和腹腔镜子宫切除术后前两天的疼痛情况及肺功能。
计划接受腹式子宫切除术的女性被前瞻性随机分为腹腔镜组（n = 20）和腹式组（n = 20）。患者通过装有吗啡的可编程输液泵自行给药。术后疼痛采用视觉模拟评分法进行评估。用血氧仪测量血氧饱和度。肺功能通过测量呼气峰值流速的峰值流量计和测量用力肺活量及一秒用力呼气量的肺活量计进行评估。
腹腔镜子宫切除术后第一天（p < 0.05）和第二天（p < 0.01）的疼痛评分较低。与术前值相比，两组术后第1天和第2天的肺功能均受损，表现为呼气峰值流速、用力肺活量和一秒用力呼气量。与接受腹式子宫切除术的患者相比，接受腹腔镜子宫切除术的患者术后第一天的呼气峰值流速（p < 0.01）、用力肺活量（p < 0.05）和一秒用力呼气量（p < 0.05）的肺功能损害较小。术后第二天，两组之间在呼气峰值流速（p < 0.05）和一秒用力呼气量（p < 0.05）方面仍存在差异。
与腹式子宫切除术相比，腹腔镜子宫切除术导致的疼痛较轻，呼吸功能损害较小。
