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。
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.
关键词
胸腔镜手术； /
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术后同侧肩痛； /
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牛津大学关节评分
Key words
Thoracoscopic surgery; /
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Postoperative ipsilateral shoulder pain; /
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Oxford Shoulder Score
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参考文献
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基金
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）
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