脑肿瘤患者开颅术后头痛的影响因素分析及护理对策

Influence factors and nursing strategies for postoperative headache in patients with brain tumors after craniotomy

目的 探讨脑肿瘤患者开颅术后头痛的影响因素,并提出护理对策.方法 采用方便抽样法,选取2016年3—9月首都医科大学附属北京天坛医院神经外科开颅术后脑肿瘤患者,采用疼痛视觉模拟评分法评估患者的疼痛情况,根据疼痛强度划分为轻度疼痛、中度疼痛和重度疼痛,分析脑肿瘤患者开颅术后疼痛的影响因素,提出护理对策.结果 62%的脑肿瘤开颅术后患者出现中重度头痛,其中男患者多于女患者,幕上肿瘤患者多于幕下肿瘤,差异均有统计学意义（χ2值分别为57.961、20.636;P〈0.01）,开颅术后不同并发症的患者,疼痛发生情况差异有统计学意义（P〈0.05）;Logistic回归分析结果显示,性别、肿瘤部位影响脑肿瘤患者开颅术后头痛严重程度.结论 脑肿瘤开颅术后患者存在不同程度的疼痛,针对疼痛影响因素制定相应护理措施,有利于改善患者疼痛状况.

Objective To explore the influence factors and nursing strategies for the postoperative headache in patients with brain tumors.Methods Totals of 100 patients with brain tumors who received the craniotomy in Beijing Tiantan hospital during March to September 2016 were selected into the study by using convenience sampling. According to the pain visual analogue scale, the participants were divided into three groups regarding their pain levels including mild pain, moderate pain, and severe pain. Analysing the potential influence factors for the postoperative headache and providing related nursing strategies.Results Approximately 62% of the patients had a moderate or severe headache, with more males than females （χ2=57.961,P〈0.05）. Patients with supratentorial neoplasms had more pain cases compared with patients with infratentorial neoplasms （χ2=20.636,P〈0.05）. There was a significant difference between patients with different complications （P〈0.05）. The Logistic regression suggested that the sex and tumor location were independent risk factors for the severity of the postoperative headache.Conclusions Different degrees of postoperative headache occurs in patients with brain tumors. The related nursing intervention should be implemented based on different influence factors for the pain.