学龄前唇腭裂患儿术后疼痛的护理干预效果评价

Nursing intervention and evaluation of postoperative pain in preschool children with cleft lip and palate

目的：观察学龄前唇腭裂患儿术后疼痛的发生率及疼痛程度，探讨护理干预对减轻疼痛的效果。方法选取2011年5-10月住院的3~7岁学龄前唇腭裂患儿120例，随机分为对照组及试验组1、2、3，每组30例。对照组采用常规护理方法，试验组1采用常规护理加镇痛药物治疗，试验组2采用常规护理加心理护理干预方法，试验组3采用常规护理加心理护理干预并辅以镇痛药物治疗。分别在术后6、12、24、48h，运用疼痛评估量表对4组患儿进行疼痛自评，以及家长、护士评分，比较其评分结果。结果4组患儿术后疼痛的发生率为50.0%~73.3%。4组间疼痛评分的差异有统计学意义（P〈0.001），试验组1、2与对照组之间的差异无统计学意义（P=0.871），而试验组3与其余3组间的差异均有统计学意义（P〈0.001）。结论学龄前唇腭裂患儿术后疼痛发生较为普遍；采用心理护理干预加镇痛药物治疗的方法，可有效缓解其术后疼痛。

Objective This study aimed to observe the postoperative pain rate and degree of pain in preschool children with cleft lip and palate, and investigate the effect of nursing intervention on pain relief. Methods A total of 120 hospitalized cases of three- to seven-year-old preschool children with cleft lip and palate were selected from May to October 2011. The subjects were randomly divided into the control group and experimental groups 1, 2, and 3. The control group used conven-tional nursing methods, experimental group 1 used analgesic drug treatment, experimental group 2 used psychological nursing interventions, and experimental group 3 used both psychological nursing intervention and analgesic drug treatment. After 6, 12, 24, and 48 h, pain self-assessment, pain parent-assessment, and pain nurse-assessment were calculated for the four groups using the pain assessment forms, and their ratings were compared. Results The postoperative pain rates of the four groups ranged from 50.0% to 73.3%. The difference among the four groups was statistically significant （P〈0.001）. The differences among the control group and experimental groups 1 and 2 were not statistically significant （P=0.871）, whereas the differences among experimental group 3 and the other groups were statistically significant （P〈0.001）. Conclusion Postoperative pain in preschool children with cleft lip and palate is common. Psychological nursing intervention with analgesic treatment is effective in relieving postoperative pain.