临床外科杂志 ›› 2019, Vol. 27 ›› Issue (12): 1033-1036.doi: 10.3969/j.issn.1005-6483.2019.12.007

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罗哌卡因局部用于微创食管癌术后腹部正中切口镇痛的效果及可行性研究

  

  1. 435000 湖北省黄石市鄂东医疗集团市中心医院
  • 出版日期:2019-12-20 发布日期:2019-12-20
  • 通讯作者: 杨帆,Email:7622032@qq.com

A Study on the effect and feasibility of Ropivacaine in killing local postoperative midabdominal incision pain in patients with minimally invasive esophageal cancer

  1. Department of Cardiothoracic Surgery,Huangshi Central Hospital,the Affiliated Hospital of Hubei Polytechnic University,Edong Healthcare Group,Hubei, Huangshi 435000,China
  • Online:2019-12-20 Published:2019-12-20

摘要:

目的 探讨罗哌卡因局部用于微创食管癌术后腹部正中切口镇痛的效果及可行性。方法 2017年3月~2018年9月我院收治的胸段食管癌病人134例,均行胸腹腔镜联合食管胃部分切除食管胃颈部吻合术。根据腹部正中切口处理方式不同分为两组,A组66例,术中腹部正中切口无特殊处理,B组68例,术中腹部正中切口留置一次性静脉输液针针管、术后局部使用罗哌卡。比较两组病人术后腹部正中切口疼痛评分(VAS)、脂肪液化以及感染等相关并发症发生情况。结果 与A组比较,B组病人术后第1~3天腹部正中切口疼痛评分(VAS)较低,分别为(4.1±0.9分)比(3.1±0.8分)、(4.0±0.9分)比(2.9±0.9分)、(3.7±0.8分)比(2.7±0.8分),差异有统计学意义(P<0.05);术后应用止疼药物(曲马多)人数占比较少,分别为36.36%(24/66)和11.76(8/68),差异有统计学意义(P<0.05),两组病人术后腹部正中切口脂肪液化、感染等的发生率比较,差异无统计学意义(P>0.05),两组均无腹腔感染病例。结论 微创食管癌术后使用罗哌卡因行腹部正中切口局部镇痛安全可行、效果确切。

关键词: 胸腹腔镜联合根治, 腹部正中切口, 罗哌卡因

Abstract: Objective To investigate the effect and feasibility of ropivacaine in local postoperative abdominal incisional pain in patients with minimally invasive esophageal cancer.Methods A retrospective analysis of 134 patients with thoracic esophageal cancer treated by thoracic and laparoscopic radical treatment at the Cardiothoracic Surgery from March 2017 to September 2018.Patients were divided into two groups.Group A(66 cases) were patients who didn’t have disposable venous infusion needle left in the abdominal incision during the surgery and didn’t take ropivacaine after the surgery while group B(68 cases)  were patients who had indwelled disposable intravenous infusion needle at the abdominal incision during the surgery and have taken ropivacaineafter the surgery.Abdominal median incision pain score,postoperative fat liquefaction,infection and other related complicationsof the two groups were compared after the surgery.Results Compared with group A patients,the median abdominal incision pain score(VAS)was lower in the group B in the first three days after the surgery,which was(4.1±0.9)VS(3.1±0.8),(4.0±0.9)VS(2.9±0.9),(3.7±0.8)VS(2.7±0.8),respectively,and the difference was statistically significant(P<0.05).Patients who had taken additional analgesic drugs(tramadol)were few[36.36%(24/66)VS 11.76(8/68) ,P<0.05].There was no significant difference in fat liquefaction and infection between median abdominal incisions(P>0.05).No cases of abdominal infection were found in both groups.Conclusion Ropivacaine for localized minimally invasive esophageal carcinoma is effective for the postoperative abdominal incision analgesia;meanwhile it does not increase the incidence of fat liquefaction,infection and abdominal infection in the middle abdominal incision,which is ideal method for minimally invasive esophageal cancer.

Key words: thoracoscopy combined with radical treatment, abdominal median incision, Ropivacaine

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[2] 吴秀玲 姜曙祥 王新闻 . 不同小剂量低浓度罗哌卡因用于老年患者腰-硬联合麻醉的研究 [J]. 临床外科杂志, 2013, 21(2): 128-130.
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