肝动脉化疗栓塞术后肝区疼痛的调查及护理对策

Investigation on liver pain of patients with hepatic arterial chemoembolization and its nursing countermeasures

目的探讨肝动脉化疗栓塞术后肝区疼痛的发生情况及护理对策。方法选择肝癌晚期患者160例随机分为对照组和观察组,对照组采用常规护理模式,观察组在此基础上采用针对性护理策略,具体包括心理护理、体位指导、放松训练以及疼痛转移相关锻炼,分析护理干预前后2组患者SAS、SDS以及CSCL-90评分,并比较护理干预后2组患者手术后视觉疼痛等级(VAS)以及WTO疼痛分级。结果 2组患者护理干预前均表现出明显的焦虑和抑郁,护理干预后,观察组患者SAS和SDS评分均显著低于干预前(P<0.05),而对照组护理干预前后SAS和SDS无显著差异(P>0.05);干预后,观察组SAS和SDS评分均显著低于对照组(P<0.05)。观察组SCL-90量表中躯体化、强迫、人际关系敏感、抑郁以及敌对情绪均显著低于对照组(P<0.05)。观察组术后VAS评分显著低于对照组(P<0.05);WHO疼痛等级结果显示,观察组在0级和Ⅰ级的占比显著高于对照组,2组疼痛分级有显著差异(P<0.05)。结论肝癌患者行肝动脉化疗栓塞术后肝区疼痛的发生率较高,采用心理干预、体位指导、放松训练以及疼痛转移等护理,有助于降低患者疼痛等级以及对止痛药特别是阿片类止痛药的需求,值得临床推广使用。

Objective terial chemoembolization and its To investigate the incidence of liver nursing countermeasures. Methods pain of patients with hepatic ar- A total of 160 patients with ad- vanced liver cancer in our hospital were randomly divided into control group and observation group. The control group used conventional mode, and the observation group were treated with targeted care strategy based on the conventional care, including psychological care, postural guidance, relaxation training, and pain-related exercise, SAS, SDS and CSCL-90 rating before and after different nursing intervention were compared, and visual pain level （VAS） and the WTO pain rating were analyzed. Results There was no significant difference in anxiety and depression of two groups before nursing. After nursing intervention, SAS and SDS scores of two groups were significantly lower than interven- tion before （ P 〈 0.05 ）, there was no significant difference in SAS and SDS of control group after nursing intervention （ P 〉 0.05 ）, and SDS and SAS scores in the observation group were significantly lower than of the control group （ P 〈 0.05 ）. After targeted nursing intervention, somatization, inter- personal sensitivity, depression and hostility were significantly lower than that in the control group （ P 〈 0.05 ）, VAS score in the observation was lower than that in the control group （ P 〈 0.05 ）. Ratio of patients with 0 and I degree of pain was significantly higher in the observation group （ P 〈 0.05 ）, and there was significant difference in pain rating in two groups. Conclusion Incidence of liver pain for patients with liver cancer hepatic artery chemoembolization is higher, nursing such as psychologi- cal intervention, postural guidance, relaxation training, and transfer of pain can help reduce pain and demand for painkillers, particularly for opioid analgesics, so it is worthy of clinical recommendation.