术前疼痛教育对开胸术后疼痛控制效果的影响

Influence of preoperative pain education on pain control effect of patients after thoractomy

目的:探讨术前疼痛教育对开胸术后疼痛控制效果的影响。方法:将135例行胸部择期手术患者按随机数字表法分为试验组68例和对照组67例。术前对照组接受常规教育,试验组在常规教育的基础上,由经过严格培训的疼痛教育小组开展疼痛教育,术后第2 d下午由患者填写"患者疼痛认知及住院期间疼痛情况调查问卷";出院前1 d研究者统计每位患者的术后24 h和48 h睡眠时间、住院时间等。比较两组患者对术后疼痛控制的认识,所采取的疼痛控制行为及疼痛控制效果。结果:试验组对疼痛控制的认知得分高于对照组(P<0.05),术后主动下床活动时间早于对照组(P<0.05),主动进行深呼吸及咳嗽得分高于对照组(P<0.05),术后采取深而慢呼吸法、听音乐、保护手术切口法及选择自控镇痛泵镇痛和疼痛呼叫的例数均多于对照组(P<0.05),术后12,24,48 h疼痛分值均低于对照组(P<0.05),术后所经历的最痛低于对照组(P<0.05),术后睡眠时间多于对照组(P<0.05),平均住院时间短于对照组(P<0.05)。结论:术前疼痛教育,可有效提高开胸患者的疼痛知识、态度及管理疼痛的能力,提高镇痛质量,促进患者康复。

Objective： To explore the influence of preoperative pain education on pain control effect of patients after thoractomy. Methods： 135 patients with thoractomy were randomly divided into experimental group of 68 cases and control group of 67 cases. The control group was instructed with routine pain education before operation, and the observe group was instructed with pain education on the basis of regular education by pain - nursing group,the second day after operation, patients filled out the questionnaire of pain cognitive and situation, compared the knowledge, behavior and effect of postoperative pain control between the two groups. Results ：The score of postoperative pain control knowledge and behavior （P 〈 0.05 ） of the observe group both higher than those of the control group. The postoperative 12,24,48 h pain score of the observe group both lower than those of the control group （ P 〈 0. 05）. The most pain experience of the observe group close to the preoperative expected （P 〈 0.05 ）, and that of the control group over the preoperative expected level （ P 〈 0.05）. Postoperative sleep time and average stay of the two groups also have statistically significant （ P 〈 0.05 ）. Conclusion： Preoperative pain education can improve the pain control knowledge,attitude and management ability of patients with chest operation, improve the quality of analgesia.