慢性伤口患者基础疼痛及换药相关疼痛的调查分析

An investigation of baseline pain and dressing change-related pain among patients with chronic wounds

目的了解慢性伤口患者基础疼痛及换药相关疼痛情况,以采取针对性措施减轻患者痛苦。方法采用自行设计的慢性伤口相关疼痛经历评估表对192例慢性伤口患者进行调查。结果 87.5%慢性伤口患者存在伤口基础疼痛;不同类型慢性伤口基础疼痛评分比较,差异有统计学意义(P<0.01),其中下肢动脉溃疡患者疼痛评分最高;镇痛药、分散注意力和采取舒适体位是减轻基础疼痛比较有效的措施。94.3%慢性伤口患者存在换药相关疼痛;慢性伤口不同换药阶段疼痛评分比较,差异有统计学意义(P<0.01),其中清洗伤口和清创时疼痛评分最高;换药过程中短暂休息、分散注意力和换药时有支持关系存在等是缓解换药相关疼痛有效的措施。结论慢性伤口患者普遍存在基础疼痛和换药相关疼痛,医务人员需要在全面评估患者疼痛情况的基础上制定个性化的镇痛方案,以减轻患者疼痛程度。

Objective To examine baseline pain and dressing change-related pain experience among patients with chronic wounds. Methods A total of 192 patients with chronic wounds were investigated using a self-made questionnaire regarding perceived pain as- sociated with chronic wounds. Results It was found that 87.5% of the participants experienced baseline pain and there was a signifi- cant difference in baseline pain levels among patients with different types of chronic wounds（P〈0.01）, with patients developing lower extremity arterial ulcers suffering the most. Analgesics, distraction methods and comfortable position were considered effec- tive strategies to relieve baseline pain. It was observed that 94.3% of the participants experienced dressing change-related pain. A significant difference in pain levels was found among patients at different dressing change stages for the same kind of chronic wound （P〈0.01）, with patients undergoing wound cleaning and debridement suffering the most. Brief rest, distraction and presence of relatives for support during dressing change were considered effective strategies which could relieve dressing change-related pain. Conclusion Baseline pain and dressing change-related pain were common among patients with chronic wounds, and medical staff should formulate individualized plans based on overall evaluation of patientsr pain condition, so as to relieve pain for them.