腹腔镜手术后除躯体创伤疼痛,部分患者还可能经历痛苦的术后内脏痛,不仅使患者术后体验不佳,疼痛应激甚至可能加重机体的内环境紊乱,不利于患者的术后康复。内脏痛是来源于内脏器官和组织的疼痛,其产生与脏器的平滑肌痉挛、扩张、缺血、化学炎症刺激等密切相关。在这个过程中,许多离子通道和受体在调节内脏伤害性刺激信号的传导上发挥作用。目前,临床上术后镇痛治疗方案多样,但如何针对性地控制术后内脏痛是临床医生需要面对和解决的问题。为此,该文对腹腔镜术后内脏痛发生的相关机制、内脏感觉的神经传导及临床特征、治疗进展进行综述。

In addition to physical trauma,patients undergoing laparoscopic surgery may also experience postoperative visceral pain．This pain not only impacts the patient's postoperative experience,but can also worsen the body's internal environment and hinder recovery．Visceral pain originates from internal organs and tissues．It is closely related to smooth muscle spasms,dilations,ischemia,and chemical inflammatory stimulation of organs．In this process,numerous ion channels and receptors regulate the transmission of visceral nociceptive stimulus signals．At present,there are multiple clinical treatment options available for postoperative pain management．However,clinicians must overcome the challenge of controlling postoperative visceral pain．This article provides a review of the relevant mechanisms of visceral pain following laparoscopic surgery,the neural conduction of visceral sensation,clinical characteristics and treatment advancements．

目的 分析抽检血液成分关键指标结果并采用趋势分析方法进行评估。方法 收集整理2015—2017年每月1次的8种血液成分质量控制的检测数据,选择关键指标并制作折线图,联合行动限和警戒限进行趋势分析。结果 未能100%达到GB 18469—2012《全血及成分血质量要求》的项目包括悬浮红细胞容量及Hct、单采血小板及浓缩血小板血小板含量、新鲜冰冻血浆及冷沉淀VIII因子含量。新鲜冰冻血浆及冷沉淀的VIII因子含量项目分别出现10次和5次偏离数据;单采血小板及浓缩血小板的血小板含量项目分别出现3次和4次偏离数据。结论 根据血液成分的关键指标结果进行趋势分析发现问题,主动寻找原因并及时采取相应措施,是确保血液质量的一种有效手段。

Objective To analyze and evaluate the results of key indexes of the blood component by trend analysis. Methods Collected and arranged the data of eight kinds of blood component quality control,which was did once month in 2015-2017.Selected the key indexes and made the line charts.Allied with the action limits and warning limits for trend analysis. Results The key indexes could not 100% meet the “Quality requirements for whole blood and component blood”,including capacity and Hct of suspended red blood cell,platelet content of apheresis platelets and platelets concentrate,factor VIII content of fresh frozen plasma and cryoprecipitate.The factor VIII of fresh frozen plasma and cryoprecipitate showed ten and five deviation data, respectively, the platelet content of apheresis platelet and platelets concentrate showed three and four deviations, respectively. Conclusion It's an effective way to ensure blood quality by trend analysis based on the results of key indexes of blood components, and actively find the cause and take corresponding measures in time.