重睑术后疼痛评估研究.docVIP

重睑术后疼痛评估研究 　　[摘要]目的：本研究是用数字评价量表numeric rating scale（NRS）来调查疼痛强度以及疼痛、瘀青、肿胀、瘙痒、生活受限和视力模糊出现的高峰期和重睑术后疼痛持续时间，为患者术前咨询和教育提供客观依据。方法：局麻重睑术后，用NRS来评价患者的疼痛程度。于术后即刻、术后2～4h、术后1d、2d、3d、7d和1个月，分别评价患者的疼痛程度。同时评价疼痛、瘀青、肿胀、瘙痒、生活受限和视力模糊出现的高峰期。共120名患者（240个上睑）参与本研究。结果：重睑术后疼痛高峰期是4.7h，肿胀高峰期是16.3h，瘀青高峰期是35.6h，瘙痒高峰期是22.1h，生活受限高峰期是17.5h，视力模糊高峰期是8.9h。严重疼痛大多出现在术后即刻到术后2～4h。结论：重睑术后的疼痛大多是轻到中度疼痛，评分不会超过4分，疼痛可持续到术后7d。在这些结果基础上的疼痛评估和治疗是有效的。 　　[关键词]重睑术；疼痛；瘀青；肿胀；瘙痒；评估；术前咨询 　　[中图分类号]R622 [文献标志码]A [文章编号]1008-6455（2015）20-0027-03 　　Abstract： Objective This study was undertaken to investigate the pain intensity， time to peak of pain， bruise，swelling，itching，life limitation，blurred vision，and duration of pain after eyelid blepharoplasty using a survey of pain scale，and to provide objective evidence to aid in education and preoperative counseling of our patients. Methods After pain assessment of the immediate postoperative period， the evaluation was repeated after 2 to 4 hours，1day，2 days，3 days，7 days，and 1 month.Time to peak of pain，bruise，swelling，itching，life limitation，and blurred vision after surgery were investigated.A total of 240 eyelids（120patients）were included. Results Time to peak after eyelid blepharoplasty was as follows：pain 4.7 hours；swelling 16.3 hours；bruise 35.6 hours；itching 22.1 hours；limitation of life 17.5 hours；and blurred vision 8.9hours.Most severe pain was observed during the immediate postoperative period and up to 2 to 4 hours after surgery. Conclusion Pain after eyelid blepharoplasty was mostly mild to moderate and did not exceed a score of 4，and could remain persistent for up to 7 days after surgery.Specific pain-targeted assessment and treatment based on these results are warranted. 　　Key words：eyelid blepharoplasty；pain；bruise；swelling；itching；assessment；preoperative counseling 　　随着人们生活水平的不断提高和对美的追求日益增加，重睑术已经成为最常见的美容手术之一[1]。许多重睑手术是在门诊局麻下完成的。学者们主要关注手术技术、麻醉方法，但是一些局麻手术如门诊上睑整形术后，没有重视对疼痛的评估和处理[2]。 　　严重疼痛和疼痛治疗后的疗效是术后最常见问题。对疼痛程度或严重性的评价是指导治疗的重要部分[3]。目前，关于局麻下重睑术后的疼痛评估尚未见报道。本研究的目的