皮肤软组织扩张术患者疼痛情况及影响因素研究

Pain Level and Influencing Factors in Patients Undergoi Skin Soft Tissue Expansion

目的了解皮肤软组织扩张术患者的疼痛情况,并分析其影响因素,为患者疼痛管理提供依据。方法调查2017年3月至12月行扩张器注水的220例患者的一般资料、社会支持水平、疼痛自我效能,应用疼痛数字评价量表(NRS-10)评估患者在扩张器注水期间的疼痛水平,并对疼痛的影响因素进行分析。结果患者在注水过程中疼痛水平最高,平均(6.75±1.25)分;注水后疼痛逐渐减轻,注水后1h降至(2.94±1.28)分。女性、年轻患者、首次埋置扩张器者、扩张器位置为头面部者的疼痛水平显著较高(P<0.05)。第17~24次注水时疼痛水平显著较低(P<0.05)。患者注水中的疼痛水平与疼痛自我效能感呈负相关(P<0.01)。结论应用皮肤软组织扩张术的患者在注水过程中的疼痛变化规律以及疼痛的影响因素值得关注,以便于评估疼痛发生的原因,识别需要疼痛管理的重点人群,提高患者的疼痛自我效能,以减轻患者疼痛。

Objective To observe the pain level of patients during skin soft tissue expansion and analyze the influencing factors,so as to provide evidence for the management of patients’pain.Methods From March 2017 to December 2017,220 patients treated by tissue expansion were included.General data,social support level,and pain self-efficacy scale were investigated.NRS-10 scale was used to evaluate the patients’pain level during the expansion procedure.The influencing factors of pain were analyzed.Results The patient had the highest pain level 6.75±1.25 points during the expansion,then gradually decreased,and fell to 2.94±1.28 points 1 hour after expansion.Pain levels reported by women,young patients,first-time tissue expansion,and head-face tissue expansion were significantly higher(P<0.05).The pain level was significantly lower at the 17th to 24th expansion(P<0.05).The pain level during expansion was negatively correlated with patient pain self-efficacy(P<0.01).Conclusion The change law of pain during tissue expansion procedure and the influencing factors are worthy of attention,in order to help assessing the cause of pain,identify key populations who need pain management and improve patient's pain self-efficacy,so as to reduce expansion pain.Key words: