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护理学报 ›› 2023, Vol. 30 ›› Issue (14): 52-58.doi: 10.16460/j.issn1008-9969.2023.14.052

• 循证护理 • 上一篇    下一篇

妇科腹腔镜患者术后肩部疼痛防治最佳证据总结

林少英1, 冯锦屏1, 侯桂珊1, 范秀春1, 何雪梅1, 李庆东1, 刘丽萍2   

  1. 1.佛山市妇幼保健院,广东 佛山 528000;
    2.南方医科大学南方医院,广东 广州 510000
  • 收稿日期:2022-11-25 出版日期:2023-07-25 发布日期:2023-08-04
  • 通讯作者: 冯锦屏(1976-),女,广东佛山人,本科学历,学士,主任护师。E-mail:48591740@qq.com
  • 作者简介:林少英(1975-),女,广东江门人,本科学历,学士,主任护师。
  • 基金资助:
    2021年广东省中医药局课题(20211373)

  • Received:2022-11-25 Online:2023-07-25 Published:2023-08-04

摘要: 目的 总结妇科腹腔镜患者术后肩部疼痛预防的最佳证据,为防治术后肩部疼痛提供循证依据。方法 运用循证护理的方法,检索相关数据库从建库至2022年5月针对妇科腹腔镜患者术后肩部疼痛防治的临床决策、指南、证据总结、专家共识、系统评价、随机对照研究、综述。结果 共纳入19篇文献,从疼痛评估与识别、患者教育、术中干预模式管理、术后体位干预、物理康复、心理护理、动态观察及记录、术后药物干预等方面总结24条最佳证据。结论 临床医护人员可通过最佳证据的临床转化及应用来减少妇科腹腔镜患者术后肩部疼痛发生率和严重程度,促进患者康复。

关键词: 妇科, 腹腔镜, 肩部疼痛, 围手术期, 循证护理

中图分类号: 

  • R473.71
[1] Balikoglu M, Bayraktar B, Filiz D,et al.The effect of experience on the outcomes of total laparoscopic hysterectomy surgery:1295 cases[J]. Ginekol Pol, 2023, 93(9):681-685. DOI: 10.5603/GP.a2021.0243.
[2] Kietpeerakool C, Rattanakanokchai S,Yantapant A,et al.Pulmonary recruitment maneuver for reducing shoulder pain after laparoscopic gynecologic surgery:a network Meta-analysis of randomized controlled trials[J].Minim Invasive Surg,2020(20):7154612.DOI: 10.1155/2020/7154612.
[3] Vilos GA,Ternamian A,Laberge PY,et al.Guideline No. 412:laparoscopic entry for gynaecological surgery[J]. J Obstet Gynaecol Can,2021,43(3):376-389.e1. DOI: 10.1016/j.jogc.2020.12.012.
[4] Aromataris E, Fernandez R, Godfrey CM,et al.Summarizing systematic reviews:methodological development,conduct and reporting of an umbrella review approach[J]. Int J Evid Based Healthc,2015, 13(3):132-140.DOI:10.1097/XEB.0000000000000055.
[5] 卢舒颖,刘宁,魏璐华,等.产后出血预防及管理的最佳证据总结[J]. 护理学报, 2020,27(12):18-22.DOI:10.16460/j.issn1008-9969.2020.12.018.
[6] Brouwers MC,Kho ME,Browman GP,et al.AGREE II:advancing guideline development,reporting and evaluation in health care[J].CMAJ,2010,182(18):E839-E842.DOI:10.1503/cmaj.090449.
[7] Brouwers MC,Kho ME,Browman GP,et al.AGREE II:advancingguideline development,reporting,and evaluation in health care[J].Prev Med,2010,51(5):421-424.DOI:10.1016/j.ypmed.2010.08.005.
[8] JBI.Critical appraisal tools[EB/OL].(2017-07-15)[2020-03-20].http://joannabriggs.org/research/critical-appraisal-tools.html.
[9] JBI. Checklist for text and opinion[EB/OL].(2017-07-15)[2020-03-20]. http://joannabriggs.org/research/critical-appraisal-tools.html.
[10] JBI.Joanna Briggs Institute Reviewers Manual2017[EB/OL].(2022-10-30).https://bibleappsfree.com/2022/07/joanna-briggs-institute-reviewers-manual-2017/.
[11] 王春青,胡雁.JBI证据预分级及证据推荐级别系统(2014版)[J].护士进修杂志,2015,30(11):964-967.DOI:10.16821/j.cnki.hsjx.2015.11.002.
[12] Aurora Pryor, William J Mann, Andrew T Bates.Complications of laparoscopic surgery[EB/OL].[2020-07-12].https://www.uptodate.com/contents/complications-of-laparoscopic-surgery.
[13] NICE. Perioperative care in adults [EB/OL].[2020-08-19]. https://www.nice.orguk/guidance/ng180.
[14] APS,ASRA,ASA.Assessment and management of pain third edition[J].J Pain,2016,17(2)131-157.
[15] Chou R,Gordon DB,Leon-Casasola OA,et al.Management of postoperative pain:a clinical practice guideline from the American Pain Society,the American Society of Regional Anesthesia and Pain Medicine,and the American Society of Anesthesiologists' Committee on Regional Anesthesia, Executive Committee, and Administrative Council[J]. J Pain, 2016,17(2):131-157.DOI:10.1016/j.jpain.2015.12.008.
[16] Reaza-Alarcón A, Rodríguez-Martín B.Effectiveness of nursing educational interventions in managing post-surgical pain. Systematic review[J].Invest Educ Enferm, 2019,37(2):e10.DOI:10.17533/udea.iee.v37n2e10.
[17] Ju W, Ren L,Chen J,et al.Efficacy of relaxation therapy as an effective nursing intervention for post-operative pain relief in patients undergoing abdominal surgery:a systematic review and Meta-analysis[J]. Exp Ther Med, 2019,18(4):2909-2916.DOI:10.3892/etm.2019.7915.
[18] Nguyen DH.JBI Evidence Summary: Patient controlled analgesia:acute care[EB/OL].[2021-04-13].https://ovidsp.dc2.ovid.com/ovid-b/ovidweb.cgi.
[19] Zeeni C, Chamsy D, Khalil A, et al.Effect of postoperative Trendelenburg position on shoulder pain after gynecological laparoscopic procedures:a randomized clinical trial[J].BMC anesthesiol,2020,20(1):27.DOI:10.1186/s12871-020-0946-9.
[20] van Dijk JEW, Dedden SJ,Geomini PMAJ,et al.Post laparoscopic reduction of pain by combining intraperitoneal normal saline and thepulmonary recruitment maneuver (POLAR BEAR trial). RCT to estimate reduction in pain after laparoscopic surgery when using a combination therapy of intraperitoneal normal saline and the pulmonary recruitment maneuver[J]. BMC Women's Health,2017,17(1):42. DOI:10.1186/s12905-017-0397-8.
[21] Radosa JC,Radosa MP,Schweitzer PA,et al.Impact of different intraoperative CO2 pressure levels(8 and 15 mmHg) during laparoscopic hysterectomy performed due to benign uterine pathologies on postoperative pain and arterial pCO2:a prospective randomised controlled clinical trial[J]. BJOG,2019,126(10):1276-1285.DOI:10.1111/1471-0528.15826.
[22] 朱云飞,袁冬儿,陈润清,等.子午流注中药热熨对妇科腹腔镜术后非切口疼痛的效果研究[J].护理学报,2016,23(24):4.DOI:10.16460/j.issn1008-9969.2016.24.001.
[23] 潘晓晶,张瑾,陈艳玲,等.延长氧疗时间对妇科腹腔镜术后病人非手术切口疼痛的影响[J].护理研究, 2017,31(36):4705-4707.DOI:10.3969/j.issn.1009-6493.2017.36.037.
[24] Wang BJ, Wu JM, Liu YC,et al.Effect of ear acupuncture plus injection at Zusanli(ST 36)on shoulder pain and cytokines after gynecologic laparoscopic surgery[J].Journal of Acupuncture and Tuina Science,2017(15):290-295.DOI:10.1007/s11726-017-1016-9.
[25] 刘怡菲,邓鹏飞,舒爱华.超声引导下右侧膈神经阻滞对腹腔镜全子宫切除术后患者肩痛的预防效果[J].中华麻醉学杂志,2019, 39(11):3.DOI:10.3760/cma.j.issn.0254-1416.2019.11.016.
[26] 中华医学会麻醉学分会. 成人手术后疼痛处理专家共识[J].临床麻醉学杂志,2017,33(9):911-917.
[27] Kaloo P, Armstrong S,Kaloo C,et al.Interventions to reduce shoulderpain following gynaecological laparoscopic procedures[J].Cochrane Database Syst Rev,2019,1(1):CD011101.DOI:10.1002/14651858.CD011101.pub2.
[28] Sao CH, Chan-Tiopianco M, Chung KC,et al.Pain after laparoscopic surgery:focus on shoulder-tip pain after gynecological laparoscopic surgery[J]. J Chin Med Assoc,2019,82(11):819-826.DOI:10.1097/JCMA.0000000000000190.
[29] Li J, Pourrahmat MM,Vasilyeva E,et al.Efficacy and safety of patient-controlled analgesia compared with epidural analgesia after open hepatic resection:a systematic review and Meta-analysis[J]. Ann Surg, 2019,270(2):200-208.DOI:10.1097/SLA.0000000000003593.
[30] 刘丽丽. 优质护理干预在预防CO2气腹压腹腔镜术后肩痛中的应用[J].中国医药科学,2020,10(2):3.DOI:10.3969/j.issn.2095-0616.2020.02.054.
[31] Radosa JC,Radosa MP,Schweitzer PA,et al.Impact of different intraoperative CO2 pressure levels(8 and 15 mmHg)during laparoscopic hysterectomy performed due to benign uterine pathologies on postoperative pain and arterial pCO2:a prospective randomised controlled clinical trial[J]. BJOG,2019,126(10):1276-1285.DOI:10.1111/1471-0528.15826.
[32] Chaichian S, Moazzami B,Haghgoo A,et al.A new approach to an old concept for reducing shoulder pain caused by gynecological laparoscopy[J].J Reprod Infertil,2018,19(1):56-60.
[33] Leelasuwattanakul N, Bunyavehchevin S,Sriprachittichai P.Active gas aspiration versus simple gas evacuation to reduce shoulder pain after diagnostic laparoscopy:a randomized controlled trial[J].J Obstet Gynaecol Res, 2016,42(2):190-194.DOI:10.1111/jog.12868.
[34] Suginami R, Taniguchi F,Suginami H.Prevention of postlaparoscopic shoulder pain by forced evacuation of residual CO2[J].JSLS,2009,13(1):56-59.
[35] Tsai HW, Chen YJ,Ho CM,et al.Maneuvers to decrease laparoscopy-induced shoulder and upper abdominal pain:a randomized controlled study[J]. Arch Surg,2011,146(12):1360-1366.DOI: 10.1001/archsurg.2011.597.
[36] Haghgoo A, Chaichian S, Ghahremani M,et al.The use of peritoneal suction drainage to reduce shoulder pain caused by gynecological laparoscopy[J]. Arch Iran Med, 2016,19(3):173-178.DOI:10.1088/1475-7516/2016/03/004.
[37] 赵艳春,赵丽.改良头低足高截石位对妇科腹腔镜手术病人并发症发生率及舒适度的影响[J].护理研究, 2019,33(13):3.DOI:10.12102/j.issn.1009-6493.2019.13.035.
[38] 詹笑春,江美英,曹开球.排气康复操减轻腹腔镜胆囊切除术后肩部疼痛的效果观察[J].护理学杂志, 2016,31(10):109-110.DOI:10.3870/j.issn.1001-4152.2016.10.109.
[39] Standley JM.Music research in medical/dental treatment:Meta-analysis and clinical applications[J]. J Music Ther, 1986,23(2):56-122.DOI:10.1093/jmt/23.2.56.
[40] 肖智智,翁丽,罗少玲.呼吸训练在缓解妇科腹腔镜术后患者膈下疼痛中的作用[J].护理实践与研究,2018,15(10):2.DOI:10.3969/j.issn.1672-9676.2018.10.032.
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