不同缝皮材料对肺癌患者术后切口疼痛的影响

Effect of different materials for sewing leather on incision pain for patients with lung cancer

目的比较缝线与缝皮钉缝合切口对肺癌患者术后切口早期疼痛的影响，并总结护理经验。方法选取我院2011年1～12月肺癌开胸手术患者130例，对照组（缝线缝合切口）58例，观察组（缝皮钉缝合切口）72例。记录两组患者基本情况、手术麻醉情况、术后一般情况、咳嗽意愿评分、手术切口状况及主要护理干预措施，并根据简明疼痛问卷对患者术后早期疼痛情况进行评价。结果两组患者手术顺利，均痊愈出院。与对照组比较，观察组患者术后切口红肿和皮下积液发生率明显降低（P〈0．05），咳嗽意愿评分明显提高（P〈0．01），术后早期的1级、2级发生率有显著变化（P〈0．05），1级疼痛患者数增加，2级疼痛患者数减少。结论不同切口缝合材料是肺癌开胸手术患者早期疼痛发生率不同的直接影响因素，与缝线相比，缝皮钉具有痛苦小、切口美观及愈合快的特点。护理上要求多翻身、叩背，指导并鼓励患者咳嗽、咳痰，及早下床活动。

Objective To compare the effect of sutures and sewn leather nail on early incision pain for patients with lung cancer, and to summarize nursing experience. Method 130 patients with lung cancer thoracotomy from January 2011 to December 2011in our hospital was selected for the study. 58 cases with incision suturing by suture, 72 cases with incision suturing by sewn leather nail. The basic condition, anesthesia during surgery, general condi- tion after surgery, cough willingness ratings, incision condition and main nursing intervention between the two group was recorded. The post-operative pain at early stage was recorded by brief pain questionnaire. Result The pa- tients in two group was successful surgery, cured and discharged. The occurrence rate of incision swelling and sero- ma in sewn leather nail group was remarkable lower than that of sutures group（P〈0.05）. The cough willingness ratings was also higher than that of sutures group （P〈0.01）. The occurrence rate of grade I and grade II post-oper- ative pain at early stage was changed significantly（P〈0.05）. The number patients with grade I pain was increased, the number of patients with grade II pain was decreased. Conclusion The different materials for suturing was the di- rect effect factors on incision The sewn leather nail was th knock back, encourage cough pain at early stage for patients with lung cancer thoracotomy. Compared with sutures, e feature as less painful, incision nice-looking and fast healing. Multiple stand up, and sputum, early ambulation was essential during nursing.