目的 探讨无痛治疗在肛肠科围术期患者中应用的效果。方法 200例肛肠手术患者随机分为研究组和对照组,研究组100例采用多模式镇痛的无痛治疗,对照组100例采用术后疼痛不能耐受时口服塞来昔布或肌注曲马多治疗。对两组患者术后6 h疼痛评分、24 h疼痛评分、48 h疼痛评分、术后第5天疼痛评分、首次排便时疼痛评分、满意度评分等指标进行分析比较。结果 研究组患者术后6 h疼痛评分(3.6±0.6),对照组术后6 h疼痛评分(3.7±0.3),两组比较差异无统计学意义(P>0.05),术后24 h疼痛评分(2.7±0.9)分、48 h 内疼痛评分(4.3±0.4)分、第5天疼痛评分(3.1±0.6)、首次排便时疼痛评分(5.7±1.5)分,均低于对照组(5.9±0.2)、(5.6±1.3)、(6.3±0.4)、(8.9±1.5),差异有统计学意义(P<0.05);研究组满意度评分(4.6±0.3)分,高于对照组(3.4±0.6),差异有统计学意义(P<0.05)。结论 肛肠科围手术期患者实施多模式镇痛的无痛治疗,可以有效减轻患者术后疼痛、提高患者的生活质量。

Objective To evaluate the effect of painless treatment in perioperative period of anorectal surgery.Methods A total of 200 patients with anorectal surgery were randomly divided into an experimental group and a control group.The experimental group (n=100) was treated with painless multimodal analgesia.The control group (n=100) was treated with oral celecoxib or intramuscular tramadol.The pain scores of postoperative 6 h,24 h,48 h,5 d,and first defecation,as well as the satisfaction score,of the two groups were compared.Results The pain score of postoperative 6 h of the experimental group was (3.6±0.6),and that of the control group was (3.7±0.3),showing no statistical difference (P>0.05).The pain scores of postoperative 24 h (2.7±0.9),48 h (4.3±0.4),5 d (3.1±0.6),and first defecation (5.7±1.5) of the experimental group were lower than those of the control group [(5.9±0.2),(5.6±1.3),(6.3±0.4),and (8.9±1.5),respectively],and the difference was statistically significant (P<0.05).The satisfaction score of the experimental group (4.6±0.3) was higher than that of the control group (3.4±0.6)(P<0.05).Conclusion Painless treatment for perioperative anorectal patients using multimodal analgesia can effectively reduce postoperative pain and improve quality of life.