术前筛查评估对预防胸腔镜手术患者术后同侧肩痛的指导作用

doi:10.13418/j.issn.1001-165x.2024.2.18

中国临床解剖学杂志 ›› 2024, Vol. 42 ›› Issue (2): 220-224.doi: 10.13418/j.issn.1001-165x.2024.2.18

术前筛查评估对预防胸腔镜手术患者术后同侧肩痛的指导作用

林奕歆^1,2，林子诗³，刘伟珊¹，叶靖^2,3*

1.南方医科大学南方医院麻醉科，广州 510515； 2. 南方医科大学麻醉学院，广州 510515；
3. 南方医科大学珠江医院麻醉科，广州 510260

收稿日期:2023-09-04 出版日期:2024-03-25 发布日期:2024-04-23
作者简介:林奕歆（2000-），硕士研究生，研究方向：疼痛治疗，E-mail：513567670@qq.com
基金资助:
广东省科技计划项目（2016A020215120）；广东省高等教育教学改革项目（科教融合背景下“三位一体”麻醉学本科卓越医师培养模式的探索）；南方医科大学高等教育教学改革项目（CBL结合翻转课堂教学法在麻醉本科危机管理模拟教学的运用与探索）

Effect of preoperative evaluation on the prevention of postoperative ipsilateral shoulder pain in patients undergoing thoracoscopic surgery

Lin Yixin^1,2, Lin Zishi³, Liu Weishan¹, Ye Jing^2,3*

1. Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China; 2. College of Anesthesiology, Southern Medical University, Guangzhou 510515, China; 3. Department of Anesthesiology, Zhujiang Hospital, Southern Medical University, Guangzhou 510260, China

Received:2023-09-04 Online:2024-03-25 Published:2024-04-23

摘要/Abstract

摘要： 目的观察牛津大学关节评分（Oxford Shoulder Score，OSS）对胸腔镜手术患者术后同侧肩痛（ipsilateral shoulder pain，ISP）的评估效果。方法择期全麻下侧卧位胸腔镜手术患者500例，年龄18~78岁，分别于术前1 d和术后第1 d在病区面对面、术后4~6周电话随访获取OSS。对术前OSS≥19分患者数据进行独立分析，并在手术体位摆放时予以保护。结果最终纳入研究465例，术前OSS≥19分患者1%（9例），术后均未发生ISP；余456例患者中，发生ISP者3.44%（16例），其手术时间长于未发生ISP患者，术后OSS较高，术后第1 d肩关节活动受限，显著低于术前（P<0.05或0.01）。结论术中对术前OSS异常患者加以体位保护，可有效预防发生术后ISP。

关键词: 胸腔镜手术； , , 术后同侧肩痛； , , 牛津大学关节评分

Abstract: Objective To investigate the efficacy of Oxford Shoulder Score（OSS）for preventing postoperative ipsilateral shoulder pain (ISP) in patients undergoing thoracoscopic surgery. Methods A total of 500 patients who underwent selective thoracoscopic surgery in the lateral position with general anesthesia were enrolled. Complete OSS data were questioned using in-depth interviews in the afternoon before the operation and the first postoperative day, and telephone was follow-up at 4-6 weeks after the operation. Special protections and statistical analysis were designed for the patients with preoperative OSS ≥19. Results A total of 465 patients were included in the study, 16 cases presented ISP with a longer operative duration and higher postoperative OSS compared to those without ISP, and shown limitation of range of motion of ipsilateral shoulder in the first postoperative day (P<0.05 or 0.01). However, 9 cases with preoperative OSS ≥19 didn’t develop ISP. Conclusions The protective procedures of the lateral posture can minimize postoperative ISP for the patients with a high preoperative OSS.

Key words: Thoracoscopic surgery; , , Postoperative ipsilateral shoulder pain; , , Oxford Shoulder Score

中图分类号:

林奕歆, 林子诗, 刘伟珊, 叶靖. 术前筛查评估对预防胸腔镜手术患者术后同侧肩痛的指导作用[J]. 中国临床解剖学杂志, 2024, 42(2): 220-224.

Lin Yixin, Lin Zishi, Liu Weishan, Ye Jing. Effect of preoperative evaluation on the prevention of postoperative ipsilateral shoulder pain in patients undergoing thoracoscopic surgery[J]. Chinese Journal of Clinical Anatomy, 2024, 42(2): 220-224.

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术前筛查评估对预防胸腔镜手术患者术后同侧肩痛的指导作用

Effect of preoperative evaluation on the prevention of postoperative ipsilateral shoulder pain in patients undergoing thoracoscopic surgery

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