疼痛管理对全髋关节置换术患者睡眠质量的影响

Effect of pain management on sleep quality in patient after total hip arthroplasty

目的探讨全髋关节置换术后疼痛管理对缓解患者疼痛和改善睡眠质量的效果。方法将80例行初次单侧全髋关节置换术患者用Excel电子表格随机分为实验组和对照组，每组40例。实验组术前给予口服塞来昔布200mg，术后6h口服塞来昔布200mg，2次／d；VAS评分〉3分，给予肌内注射盐酸哌替啶50mg。对照组术前不给药物，术后按需给予口服塞来昔布200mg。分别于术前和术后采用匹兹堡睡眠质量指数量表（PSQI）和视觉模拟评分法（VAS）比较两组疼痛和睡眠质量。结果两组患者术前PSQI、VAS评分比较差异均无统计学意义（P〉0．05）；实验组患者术后24h的VAS疼痛评分为（2．13±1．28）分，PSQI评分为（1．83±0．84）分，对照组分别为（4．90±1．38）分和（5．55±1．40）分，观察组均低于对照组，组问比较差异有统计学意义（t值分别为5．286，7．674；P〈0．01）。结论在全髋关节置换术后实施疼痛规范化管理，可以减轻患者的疼痛，提高睡眠质量，对患者获得早期康复提供有利条件。

Objective To study the effectiveness of pain management on sleep quality of patients after total hip arthroplasty（ THA ）. Methods 80 patients with unilateral total hip replacement were recruited and equal randomly divided into experimental group and eontrol group by Excel. Each patient completed the preoperative the Pittsburgh Sleep Quality Index （PSQI） scale and visual analogue scale （VAS） to evaluate the sleep quality and pain after THA. In experimental group, oral analgesics were administrated routinely at the preoperative 48th and 24th hour and after operation, if the postoperative pain scale was larger than 3 point, extra analgesic was used. In control group, no analgesic was used pre-operation, and postoperative oral analgesics were administrated according to the requirement of the patients. Pain scale and PSQI scale were recorded at the postoperative 24 hours in both groups. Results The VAS pain score and PSQI at the postoperative 24 hours in experimental group were both significant lower than control group [ （2.13 ＋ 1.28） vs （4.90 ＋ 1.38）, （ 1.83 ＋ 0.84） vs （ 5.55 ＋ 1.40 ）, respeetively ], the difference was statistically significant （ t = 5. 286,7. 674, respectively ;P 〈 0.01 ）. Conclusions Standardization pain management after total hip replacement can relieve the postoperative pain and improve sleep quality ; it is benefit for the early rehabilitation of the patients.