疼痛护理干预对下肢动脉硬化闭塞症患者术后疼痛的影响

Effect of pain nursing intervention on patients with lower extremity arteriosclerosis obliterans after operation

目的探讨疼痛护理干预对下肢动脉硬化闭塞症(ASO)患者术后疼痛的影响及效果。方法选取2016年5月至2018年1月上海交通大学医学院附属第九人民医院血管外科行手术治疗的下肢ASO患者92例,并分为观察组和对照组,各46例。2组患者均行单侧下肢球囊扩张联合支架置入术,术后对照组给予常规护理,观察组患者在对照组基础上给予疼痛护理干预,包括疼痛评估管理、多环节评估、个体化疼痛管理、多模式健康教育、术中干预。比较2组患者入院及出院时疼痛评分(数字等级评定量表或WONG-BAKER面部表情量表)、睡眠时间、胃纳差情况、术后下床时间、住院天数及护理满意度的差异。采用SPSS 19.0软件进行统计分析。根据数据类型,组间比较采用t检验或χ2检验。结果入院时,对照组和研究组患者疼痛评分差异不显著[(3.50±1.14)和(3.50±1.10)分,P=1.000],出院时研究组患者疼痛评分显著低于对照组[(1.28±0.41)和(2.39±0.77)分,P<0.001],且与入院时比较,2组患者出院时疼痛评分均显著降低,差异有统计学意义(P<0.05)。与对照组比较,研究组术后下床时间和住院时间显著缩短,睡眠时间和护理满意度显著增加,差异有统计学意义。但2组胃纳差情况比较差异不显著(P=0.086)。结论疼痛护理干预可改善下肢ASO患者疼痛程度和睡眠质量,提高患者护理满意度。

Objective To explore the effect of pain nursing intervention on postoperative pain in the patients with lower extremity arteriosclerosis obliterans(ASO).Methods From May 2016 to January 2018,92 patients with ASO were enrolled in this study,who underwent surgical treatment in the Department of Vascular Surgery of the Shanghai Ninth People′s Hospital.They were divided into observation group and control group(46 patients each).Both groups received unilateral balloon dilatation and stenting in the lower extremity.The control group received routine nursing after operation,while the observation group received pain nursing intervention featuring pain assessment management,multi-facet assessment,individualized pain management,multimodal health education,and intraoperative intervention.The two groups were compared in postoperative pain scores(digital rating scale or WONG-BAKER facial expression scale),sleep time,anorexia,ambulation after operation,days of hospitalization,and satisfaction with nursing.SPSS statistics 19.0 was used for data analysis.Depending on the data type,t test orχ2 test is employed for comparison between two groups.Results On admission,there was no significant difference in pain score between control group and observation group[(3.50±1.14)vs(3.50±1.10),P=1.000].At discharge,the pain score of the observation group was significantly lower than that of control group[(1.28±0.41)vs(2.39±0.77),P<0.001],and the scores for both groups were significantly lower as compared with those at admission with a statistically significant difference(P<0.05).Compared with control group,the observation group had earlier ambulation after operation,shorter hospitalization,longer sleep time,and better nursing satisfaction,the difference being statistically significant.However,no significant difference was observed in appetite between two groups(P=0.086).Conclusion Pain nursing intervention can relieve pain to a greater degree,improve sleep quality in ASO patients after operation,and enhance patients′satisfac-tion with nursing.