腹腔镜操联合体位疗法缓解腹腔镜术后非切口疼痛的疗效观察

目的　探讨腹腔镜操联合体位疗法缓解腹腔镜术后非切口疼痛的临床疗效。方法　本研究为临床干预研究。研究对象为广东省第二中医院妇科2019年7月至2021年7月完成腹腔镜手术后出现非切口疼痛的患者，共90例，按随机数字表法分为3组，对照组、观察1组、观察2组，每组30例。对照组年龄（34.36±4.25）岁，观察1组年龄（35.41±3.26）岁，观察2组年龄（34.48±3.56）岁。对照组：腹腔镜术后常规给予饮食指导、运动指导、心理护理等；观察1组：在对照组的基础上采用膝胸卧位；观察2组：在观察1组的基础上指导患者做腹腔镜操。对比3组患者腹腔镜术后非切口疼痛干预后的疼痛评分、疼痛持续时间、护理满意度的差异。采用方差分析、χ²检验、秩和检验。结果　（1）疼痛评分：3组患者干预后6 h的疼痛评分比较，F=26.824，P<0.001；3组患者干预后24 h的疼痛评分比较，F=28.577，P<0.001；3组患者干预后48 h的疼痛评分比较，F=43.037，P<0.001。（2）疼痛持续时间：观察1组与对照组比较，χ²=7.460，P=0.024；观察2组与观察1组比较，χ²=0.543，P=0.762；观察2组与对照组比较，χ²=11.416，P=0.003。（3）护理满意度：对照组、观察1组、观察2组护理满意度分别为90.0%（27/30）、96.7%（29/30）、100.0%（30/30）。观察1组与对照组比较，Z=-2.065，P=0.039；观察2组与观察1组比较，Z=-2.051，P=0.040。结论　腹腔镜操联合体位疗法能明显缓解腹腔镜术后非切口疼痛，缩短疼痛持续的时间，提高患者护理满意度，且操作简单，不产生费用，无不良反应，值得临床推广。

Effect of laparoscopic exercise combined with body position therapy in relieving non-incision pain after laparoscopic surgery

Objective　To investigate the clinical effect of laparoscopic exercise combined with body position therapy in relieving non-incision pain after laparoscopic surgery. Methods　This was a clinical intervention study. The subjects were 90 patients who completed laparoscopic surgery in Department of Gynecology, Guangdong Second Traditional Chinese Medicine Hospital from July 2019 to July 2021. The 90 patients with non-incision pain after laparoscopic surgery were divided into a control group, an observation group 1, and an observation group 2 by the random number talbe method, with 30 cases in each group. The control group was (34.36±4.25) years old, the observation group 1 was (35.41±3.26) years old, and the observation group 2 was (34.48±3.56) years old. The control group was routinely given dietary guidance, exercise guidance, psychological care, etc.; the observation group 1 took knee-chest lying position on the basis of the control group; and the observation group 2 did laparoscopic exercise under instruction on the basis of observation group 1. The differences in pain score, pain duration, and nursing satisfaction after non-incision pain intervention after laparoscopic surgery were compared between the three groups. ANOVA , χ² ,and rank sum test were applied. Results　There were statistical differences in the pain scores 6, 24, and 48 h after the intervention between the 3 groups (F=26.824, 28.577, and 43.037; all P<0.001). There were statistical differences in the pain duration between the control group and the observation group 1 (χ²=7.460, P=0.024), between the observation group 1 and the observation group 1 (χ²=0.543, P=0.762), and between the control group and the observation group 2 (χ²=11.416, P=0.003). The nursing satisfaction was 90.0% (27/30) in the control group, 96.7% (29/30) in the observation group 1, and 100.0% (30/30) in the observation group 2, with statistical differences between the control group and the observation group 1 (Z=-2.065, P=0.039) and between the observation group 1 and the observation group 2 (Z=-2.051, P=0.040). Conclusions　Laparoscopic exercise combined with body position therapy can significantly relieve non-incision pain after laparoscopic surgery, shorten the duration of pain, and improve patients' nursing satisfaction. The operation is simple, costs no money, and has no side effects, so it is worthy of widespread clinical application and promotion.