视觉模拟量表和语言评价量表用于术后疼痛评估的比较

A comparison of the verbal rating scale and the visual analog scale for pain assessment in postoperative patients

目的探讨是否可以使用简单的语言评价量表代替视觉模拟量表进行手术后疼痛的评估。方法将美国麻醉医师协会(ASA)Ⅰ -Ⅲ级的120例患者依其受教育程度的高低分2组 :初中及初中以下文化程度组(Ⅰ组 ,n=45) ,高中及高中以上文化程度组 (Ⅱ组 ,n=75)。患者于术后进行视觉模拟量表(VAS)和语言评价量表(VRS)的填写。麻醉医生对如何进行量表的填写向患者进行解释 ,并记录以下数据 :每位患者VAS和VRS的数值 ,填写VAS和VRS量表前向患者解释的次数 (Nvas和Nvrs)。结果Ⅰ组和Ⅱ组的VAS和VRS评分均有显著相关性 (P<0.01) ,其相关系数分别为0.936和0.901。在Ⅰ组中Nvas较Nvrs高 (P<0.05) ,同时Nvas在Ⅰ组中较Ⅱ组中高 (P<0.05) ,但在Ⅱ组中Nvas和Nvrs无显著差异(P>0.05)。结论在对患者进行术后疼痛评定时VRS和VAS具有良好的相关性 ,而VRS更适用于文化程度低及抽象概念理解有困难的患者 。

Objective To determine if the simple Verbal Rating Scale(VRS)could be substituted for the Visual Analog Scale(VAS)to measure pain intensity in postoperative patients or not.Methods120ASA physical statusⅠ-Ⅲpatients were divided into two groups by their respective educated level:①In groupⅠ(n=45),the patients'education level were junior high school or belowit.②In groupⅡ(n=75),the patients'education level was senior high school or above it.The patients were asked to rate the postoperative pain with the VAS and VRS.The anesthetists must explain to them howto fill in the VAS and VRS sheets time and again until they understood it clearly.The following parameters were recorded:The count of VAS and VRS in every patient,the times of explanation before the patient filled in the VAS sheet(Nvas)and VRS sheet(Nvrs).Results There were significant correlation in the value in VAS and VRS in two groups(P<0.01),the respective coefficient of correlation was0.936(Ⅰgroup)and0.901(Ⅱgroup).In groupⅠ,Nvas was markedly higher than Nvrs(p<0.05),meanwhile,Nvas in groupⅠwas markedly higher than it in groupⅡ(P<0.05).But there had no marked difference between Nvas and Nvrs in groupⅡ(P>0.05).Conclusion Our results suggest that there has a well correlation between VAS and VRS for pain assessment in postoperative patients.VRS is particular applicable for the patients,such as elders who have loweducated level or have difficulty with understanding the nonobjective concept.