摘要
目的开胸手术由于创伤大,术后疼痛剧烈,会引起患者诸多心理和生理的应激反应,严重影响疾病治疗的转归及功能恢复。文中通过回顾性分析开胸手术患者术后疼痛和护理干预的相关性,评估护理干预对减轻术后疼痛的影响。方法收集2013年12月至2014年3月南京军区南京总医院心胸外科580例开胸手术患者的护理资料,将术后疼痛时间分为4期:第1期为麻醉清醒至24 h内,第2期为术后第2天,第3期为术后第3天,第4期为术后第4天后;采用危重症患者疼痛观察工具(the critical care pain observation tool,CPOT)和五指疼痛评估法进行各期疼痛评估并采取相应的干预措施,分析患者接受镇痛、雾化吸入、导管护理、体位护理、环境干预、心理干预等护理措施后的效果。结果对于患者不同时期的疼痛采用不同的护理干预措施后,术后疼痛评分逐期降低,第1-4期分别为(2.89±0.39)分、(2.25±0.90)分、(1.58±0.57)分、和(1.06±0.24)分。两两比较的差异均有统计学意义(P<0.01)。结论根据术后疼痛分期对患者疼痛采取综合护理干预措施能有效缓解开胸手术后患者的疼痛程度。
Objective Because of the major trauma from thoracotomy,postoperative pain may arouse patients＇ psychological and physiological stress response and hence affected the treatment outcome and functional recovery seriously. We retrospectively studied the correlation between the staging of pain and nursing interference to investigate the effect of nursing interference on the pain intensity after thoracic surgery. Methods Five hundred and eighty cases of patients surviving thoracotomy between December 2013 and March 2014 in Nanjing Jingling Hospital were reviewed. Correlations between comfortable nursing measures such as effective analgesia,postural care,catheter care,environmental interventions,psychological intervention and the standard assessment of pain were analysed according to postoperative pain stage. Results With comprehensive nursing interference,the highest pain score occurred in the first24 hour（ 2. 89 ± 0. 39）. The score was reduced gradually to 2. 25 ± 0. 90 in stage Ⅱ,1. 58 ± 0. 57 in stage Ⅲ and 1. 06 ± 0. 24 in stage Ⅳ respectively. Conclusion Comprehensive nursing interference according to pain staging may relieve pain effectively after thoracotomy.
出处
《医学研究生学报》
CAS
北大核心
2015年第2期189-191,共3页
Journal of Medical Postgraduates
基金
南京军区南京总医院科研基金(2012070)
