老年巨大肝癌切除术后患者基于活动性疼痛评估的护理干预

Activity-related pain assessment based nursing intervention for elder patients undergoing hepatectomy for huge hepatocellular carcinoma

目的降低老年巨大肝癌切除术后患者疼痛程度,以促进患者康复。方法将74例老年巨大肝癌切除术患者随机分为观察组和对照组,每组37例。对照组按常规进行疼痛护理,观察组在常规疼痛护理基础上,由疼痛专科护士分别于术后第1~3天的10:00和16:00采用功能活动评分法(FAS)和数字评定量表(NRS)评估患者有效咳嗽时的活动性疼痛,针对评估结果实施护理干预。结果观察组术后第2~3天FAS评级、患者活动性疼痛评分及疼痛对患者影响程度评分显著低于对照组(P<0.05,P<0.01),观察组术后首次下床活动时间、肠功能恢复情况等显著优于对照组(P<0.05,P<0.01)。结论开展活动性疼痛评估有助于为术后患者采取及时有效的护理干预措施,提高疼痛管理质量,有利于促进患者康复。

Objective To relieve pain in elder patients undergoing hepatectomy for huge hepatocellular carcinoma（HCC）,and to promote postoperative rehabilitation.Methods A total of 74 elder patients who underwent liver resection for HCC were randomly and evenly divided into an intervention group and control group.The control group received routine postoperative pain control care,while the intervention group additionally received nursing interventions which were based on activity-related pain assessment results by using Functional Activity Score（FAS）and Numerical Rating Scale（NRS）at 10：00 and 16：00 on the 1 st to 3 rd day after surgery.Results The FAS scores,activity-related pain scores and scores of impact of pain on patients on the 2 nd and 3 rd day after surgery in the intervention group were significantly lower than in the control group（P〈0.05,P〈0.01）.The time to start off-bed activities was significantly shorter,and postoperative bowel function was better in the intervention group than in the control group（P〈0.05,P〈0.01）.Conclusion Practice of postoperative activity-related pain assessment can help nurses to take timely and effective interventions,thus improve quality of pain management and boost patient recovery.