集束化干预对妇科腹腔镜术后非切口疼痛的影响

Effect of cluster nursing intervention on non-incisional pain after gynecological laparoscopic surgery

目的探讨集束化护理干预对妇科腹腔镜术后病人非切口疼痛的影响。方法将2016年7月至2017年7月中国科学技术大学附属第一医院行妇科腹腔镜手术病人120例,采用信封法随机分为观察组和对照组,每组60例,观察组采用集束化护理干预,对照组采用传统腹腔镜术后常规护理,两组均采用“长海痛尺”进行疼痛评定,并在出院前使用自制满意度调查表进行测评。结果对照组与观察组非切口疼痛发生率分别为术后6 h:71.67%,41.67%(P<0.05);术后24 h:53.33%,33.33%(P<0.05);术后48 h:23.33%,8.33%(P<0.05)。对照组与观察组疼痛评分分别为术后6 h:(5.32±2.58)分,(4.07±1.87)分(P>0.05);术后24 h:(3.02±0.85)分,(2.70±0.46)分(P<0.05);术后48 h:(1.90±0.88)分,(1.62±0.49)分(P<0.05)。对照组与观察组病人住院满意度分别为83.33%,96.66%(P<0.05)。结论集束化护理干预能有效预防和降低妇科腹腔镜术后非切口疼痛的发生,增加病人舒适度,促进术后快速康复,提高病人住院满意度及围手术期护理质量,且简便易行、经济有效,值得临床推广。

Objective To explore the effect of cluster nursing intervention on non⁃incision pain of patients after gynecological lapa⁃roscopic surgery.Methods 120 patients who underwent gynecological laparoscopic surgery in The First Affiliated Hospital of USTC from July 2016 to July 2017 were randomly divided into the observation group and the control group by envelope method.There were 60 patients in each group.The observation group was given the cluster nursing intervention,the control group was given traditional laparoscopic postoperative routine nursing care.Both of the groups received pain assessment with‘Changhai pain scale’,and were assessed with self⁃designed satisfaction questionnaire before discharge.Results Six hours after operation,the incidence of non⁃incisional pain in the control group and the observation group was 71.67%and 41.67%,respectively.24 hours after opera⁃tion,the incidence of non⁃incisional pain in the control group and the observation group was 53.33%and 33.33%,respectively.48 hours after operation,the incidence of non⁃incision pain in the control group and the observation group was 23.33%and 8.33%,re⁃spectively.The pain scores of six hours after operation were(5.32±2.58)and(4.07±1.87)in the control group and the observation group,respectively.The pain scores of 24 hours after operation were(3.02±0.85)and(2.70±0.46)in the control group and the ob⁃servation group,respectively.The pain scores at 48 hours after operation were(1.90±0.88)and(1.62±0.49)respectively in the con⁃trol group and the observation group.In the control group and the observation group,the patients’satisfaction with hospitalization was 83.33%and 96.66%respectively.The difference was statistically significant(P<0.05).Conclusion The cluster nursing inter⁃vention can effectively prevent and reduce the occurrence of non⁃incision pain after gynecological laparoscopic surgery,increase the comfort level of patients,promote postoperative rapid recovery,improve the satisfaction of patients in hospital and perioperative nursing quality,which is simple,economical and effective,worthy of clinical promotion.