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| 智能化自控静脉镇痛在老年患者腹腔镜结直肠癌根治术后应用的效果 |
| Effects of artificial intelligent patient-controlled intravenous analgesia management on postoperative application in elderly patients undergoing laparoscopic radical resection of colorectal cancer |
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| DOI：10.12089/jca.2022.04.001 |
| 中文关键词: 老年 人工智能 患者自控静脉镇痛 睡眠质量 术后镇痛 |
| 英文关键词: Aged Artificial intelligence Patient-controlled intravenous analgesia Quality of sleep Postoperative analgesia |
| 基金项目:国家重点研发计划（2018YFC2001802） |
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| 中文摘要: |
目的 研究智能化患者自控静脉镇痛（Ai-PCIA）在老年患者腹腔镜下结直肠癌根治术后应用的效果。
方法 选择2019年7月至2021年5月择期行腹腔镜结直肠癌根治术的老年患者60例，男40例，女20例，年龄≥65岁，ASA Ⅱ或Ⅲ级。采用随机数字表法将患者分为两组：Ai-PCIA组（A组）和传统PCIA组（C组），每组30例。A组通过智能化无线镇痛系统+术后每日2次随访进行术后镇痛管理和效果评价，C组通过病房医师反馈+术后每日2次随访的方式进行镇痛管理和效果评价，术后随访在8：00—9：00时和17：00—18：00进行。记录术后2、4、8、12、24、48 h静息和活动时疼痛数字评分（NRS），术前1 d、术后第1天和第2天理查兹-坎贝尔睡眠量表（RCSQ）评分，术后48 h内镇痛泵总按压次数、有效按压次数、舒芬太尼总用量、补救镇痛例数，术后住院时间，术后48 h内不良反应和心血管不良事件发生情况。
结果 术后8、12、24 h，A组静息时NRS评分明显低于C组（P＜0.05），术后8、12、24、48 h，A组活动时NRS评分明显低于C组（P＜0.05）。术后第1天、第2天A组RCSQ评分明显高于C组（P<0.05）。两组术后48 h内镇痛泵总按压次数、有效按压次数、舒芬太尼总用量和补救镇痛率差异无统计学意义。A组术后住院时间明显短于C组（P＜0.05）。两组术后48 h内不良反应和心血管不良事件发生率差异无统计学意义。
结论 Ai-PCIA可以提高老年患者腹腔镜结直肠癌根治术后镇痛效果，改善睡眠质量，缩短术后住院时间。 |
| 英文摘要: |
Objective To investigate the effect of artificial intelligent patient-controlled intravenons analgesia (Ai-PCIA) management on the postoperative analgesia in elderly patients undergoing laparoscopic radical resection of colorectal cancer.
Methods Sixty elderly patients who underwent laparoscopic radical resection of colorectal cancer from July 2019 to May 2021, 40 males and 20 females, aged ≥65 years, ASA physical status Ⅱ or Ⅲ, were selected. Patients were divided into two groups using a random number table method: Ai-PCIA group (group A) and PCIA group (group C), 30 patients in each group. In group A, the analgesic effect was evaluated and managed by the intelligent wireless analgesia system on top of twice-daily follow-up after surgery. In group C, the analgesic effect was evaluated and managed by the method of twice-daily follow-up and physician feedback after surgery. Routine follow-up after surgery were performed at 8-9 a.m. and 5-6 p.m. in both groups. NRS scores at rest and in activity were recorded at 2, 4, 8, 12, 24, and 48 hours after surgery. The Richards Campbell sleep questionnaire (RCSQ) scores on the first day before the operation, the first day and the second day after surgery were recorded. The total number of compressions, number of effective compressions, the total dose of sufentanil and number of rescue analgesia within 48 hours after surgery were recorded. The length of hospital stay after surgery was recorded. The incidence of adverse reactions and cardiac adverse events within 48 hours after surgery were recorded.
Results NRS scores at rest in group A were significantly lower than that in group C at 8, 12 and 24 hours after surgery (P < 0.05). NRS scores in activity in group A were significantly lower than that in group C at 8, 12, 24 and 48 hours after surgery (P < 0.05). The RCSQ scores in group A were significantly higher than that in group C on the first and second day after surgery (P < 0.05). There were no significant differences in the total number of compressions, the rate of effective compressions, the rate of patients with rescue analgesia and the dosage of sufentanil between the two groups within 48 hours after surgery. The postoperative hospital stay in group A was significant shorter than that in group C (P < 0.05). There were no significant differences in the incidence of adverse reactions and cardiac adverse events within 48 hours after surgery.
Conclusion Ai-PCIA can improve postoperative analgesia, improve sleep quality, and shorten the length of hospitalization after surgery in elderly patients undergoing laparoscopic radical resection of colorectal cancer. |
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