经皮穴位电刺激痛阈和耐痛阈与腹腔镜辅助下经阴道子宫切除术术后不同类型术后疼痛的相关性

目的 探讨患者术前经皮穴位电刺激(TEAS)痛阈、耐痛阈与腹腔镜辅助下经阴道子宫切除术(LAVH)术后不同类型急性术后疼痛评分的相关性。方法 选取2018年1月至2019年12月温州医科大学附属第一医院择期行LAVH患者,术前1 d使用TEAS测定并记录患者的痛阈和耐痛阈,采用数字评分法(NRS)分别对患者的术后急性内脏痛、躯体痛进行评估,使用Pearson相关性方法分析TEAS的痛阈、耐痛阈与不同类型急性术后疼痛的相关性,并分别进行线性回归分析,求出回归方程。结果 本研究202例患者中,有99例患者术后出现中至重度内脏痛,86例患者术后出现中至重度躯体痛。经Pearson相关性分析,痛阈与内脏痛呈显著负相关(r=-0.319,P0.05),耐痛阈与内脏痛之间呈显著负相关(r=-0.418,P0.05),痛阈与躯体痛呈显著负相关(r=-0.246,P0.05),耐痛阈与躯体痛之间呈显著负相关(r=-0.284,P0.05)。其回归方程分别为:Y(内脏痛评分)=-0.094 X(痛阈)+6.137,Y(内脏痛评分)=-0.089X(耐痛阈)+7.013;Y(躯体痛评分)=-0.074 X(痛阈)+4.829,Y(躯体痛评分)=-0.061X(耐痛阈)+5.221。结论 术前TEAS痛阈和耐痛阈可以在一定程度上预测LAVH患者术后急性内脏痛、躯体痛。临床上可以通过术前测定患者TEAS的痛阈和耐痛阈,并以此来客观地预测患者术后不同类型的急性术后疼痛。

Correlation between transcutaneous electrical acupoint stimulation pain threshold and pain tolerance threshold and different types of postoperative pain after laparoscope-assisted vaginal hysterectomy

Objective To investigate the correlation between preoperative transcutaneous electrical acupoint stimulation(TEAS)pain threshold,pain tolerance threshold and different types of acute postoperative pain scores after laparoscopeassisted vaginal hysterectomy (LAVH).Methods Patients with elective LAVH from the First Affiliated Hospital of Wenzhou Medical University from January 2018 to December 2019 were selected.TEAS was used to measure and record the pain threshold and pain tolerance threshold of the patients the day before the operation.The Numerical rating scale (NRS) scores were used to evaluate the patients'' postoperative acute visceral pain and somatic pain.Pearson correlation method was used to analyze the correlation between TEAS''s pain threshold,pain tolerance threshold and different types of acute postoperative pain.Linear regression analysis was performed to obtain the regression equation.Results Among the 202 patients in this study,99 patients developed moderate to severe visceral pain after surgery,and 86 patients developed moderate to severe body pain after surgery.Pearson correlation analysis showed that pain threshold was significantly negatively correlated with visceral pain (r=-0.319,P<0.05),pain tolerance threshold was significantly negatively correlated with visceral pain (r=-0.418,P<0.05),pain threshold was significantly negatively correlated with somatic pain(r=-0.246,P<0.05),and pain tolerance threshold was significantly negatively correlated with physical pain(r=-0.284,P<0.05).The regression equations were Y(visceral pain score)=-0.094X (pain threshold)+6.137,Y(visceral pain score)=-0.089X (pain tolerance threshold)+7.013;Y (somatic pain score)=-0.074 X (pain threshold)+4.829,Y (somatic pain score)=-0.061X (pain tolerance threshold)+5.221.Conclusion Preoperative TEAS pain threshold and pain tolerance threshold can predict postoperative acute visceral pain and somatic pain in LAVH patients to a certain extent.Clinically,the pain threshold and pain tolerance threshold of the patient''s TEAS can be measured before the operation,and this can be used to objectively predict the different types of acute postoperative pain in the patient.