ICU腹部外科术后患者疼痛与睡眠关系的研究

ASSOCIATION OF PAIN AND SLEEP IN ICU PATIENTS AFTER ABDOMINAL SURGERY

目的:探讨ICU中疼痛是否为ICU睡眠障碍的确定影响因素,主观疼痛指标与客观疼痛指标的关系,主观睡眠质量与客观睡眠质量的关系。方法:一共入组40名ICU腹部外科择期术后病人,记录他们的年龄、Apache Ⅱ评分、VAS评分、按压止疼泵次数、脑电图得到的深睡眠百分比、浅睡眠百分比、主诉睡眠质量等参数。根据主诉睡眠的质量分为好、中、差三组,比较三组间深睡眠百分比的差异。比较VAS与按压止疼泵次数的相关性,比较深睡眠百分比与Apache II评分、VAS评分的相关性。结果:VAS和按压止疼泵的次数呈正相关(r=0.39,P=0.013),不同的主观睡眠质量其脑电深睡眠百分比存在明显差异(P=0.004),深睡眠所占百分比与VAS和Apache Ⅱ评分存在相关性(P<0.05)。结论:按压止疼泵次数可反映患者疼痛程度,深睡眠所占百分比可反映患者主观睡眠状况,ICU中睡眠质量与疼痛和疾病的严重程度有关。

Objective：To identify whether pain is one of the main factors affecting sleep in ICU patients.To investigate the relationship between subjective pain level and objective pain level.To investigate the relationship between subjective quality of sleep and objective quality of sleep.Methods： 40 patients were included.Recorded the age,Apache II score,VAS,pressing times of patient controlled analgesia,（PCA）,deep sleep percentage with electroencephalogram,light sleep percent with electroencephalogram and subjective quality of sleep.Classified the patients into three groups according to subjective quality of sleep.Compared the difference of the deep sleep percentage among the three groups.Found the correlationship between VAS and pressing times of PCA,deep sleep percentage and Apache Ⅱ score,deep sleep percentage and VAS.Results： VAS and pressing times of PCA present significant positive correlationship（r = 0.39,P=0.013）.The quality of deep sleep showed significant difference among different groups of subjective quality of sleep（P=0.004）.There was significant correlationship between deep sleep and VAS,Apache Ⅱ（P 0.05）.Conclusion： The pressing times of PCA reflected the subjective pain level.The deep sleep percentage with electroencephalogram reflected the subjective quality of sleep.Pain and Apache Ⅱ score were associated with the dyssomnia of patients in ICU.