老年颈动脉狭窄病人外科术后疼痛影响因素和态度调查研究

Investigation of influencing factors of postoperative pain and attitudes of the elderly patients with carotid artery stenosis

目的调查研究老年颈动脉狭窄病人外科术后疼痛程度、疼痛影响因素及其对待疼痛的态度。方法选取2014年11月至2017年10月于本院血管外科行颈动脉内膜剥脱术(CEA)的129例老年病人作为研究对象,挑选符合标准的病人发放问卷或进行面对面询问,收集术后疼痛、人口学资料、病史、术中情况等信息,并运用秩和检验、多元线性回归等统计学方法分析疼痛的影响因素。结果老年颈动脉狭窄病人外科术后疼痛评分范围为1~7分,平均(3.3±1.4)分,其中轻度疼痛35例(27.1%),中度疼痛92例(71.3%),重度疼痛2例(1.6%)。多元线性回归分析结果显示:户籍、性别、治疗依从性是老年颈动脉狭窄病人外科术后疼痛评分的独立影响因素(P<0.05)。病人对待术后疼痛认知态度以恐惧为主(76.4%),解决态度以不应对为主(59.7%)。结论老年颈动脉狭窄病人外科术后疼痛普遍存在,差异较大,城市户籍、女性、治疗依从性差的病人疼痛强烈;对待疼痛态度以消极为主。

Objective To investigate the degree of postoperative pain,influencing factors and attitude towards postoperative pain in elderly patients with carotid artery stenosis. Methods A total of129 cases of elderly patients from November 2014 to October 2017 in Department of Vascular Surgery in our hospital who underwent carotid endarterectomy（ CEA） were selected as the research subjects,and they underwent questionnaires or face-to-face interview. Rank sum test and multiple linear regression statistical methods were used to analyze the influencing factors of postoperative pain. Results The postoperative pain score of elderly patients with carotid artery stenosis ranged from 1-7 points,with a mean score of 3. 3±1. 4 points. There were 35 patients（ 27. 1%） with mild pain,92 patients（ 71. 3%）with moderate pain and 2 patients（ 1. 6%） with severe pain. Multiple linear regression analysis showed that household type,gender and compliance were independent influencing factors for postoperative pain score in elderly patients with carotid artery stenosis（ P〈0. 05）. The patients＇ attitude towards postoperative pain was mainly based on fear（ 76. 4%）,and the coping attitude was mainly non-coping（ 59. 7%）. Conclusions The postoperative pain of elderly patients with carotid artery stenosis is widespread,and the difference is great. The influencing factors are various,affected mainly by household type,gender and occupation type; the attitude towards pain is mainly passive.