以护士为主体的多学科合作疼痛管理在肺癌胸腔镜手术患者的应用

Application of Multidisciplinary Cooperative Pain Administration with Nurses as the Main Body in Patients with Lung Cancer by Thoracoscopy Surgery

目的分析在肺癌胸腔镜手术(VATS)期间实行以护士为主体的多学科合作疼痛管理的价值。方法该研究对象为方便选取2018年10月—2020年5月间来该院治疗的75例肺癌VATS患者。以随机法为基准,A组39例,疼痛管理期间将护士作为主体实行多学科合作;B组36例,实行常规化疼痛管理。对比疼痛改善效果。结果A组在静息与运动状态下,各个时间点的疼痛评分更低;A组的胸腔引流时间、下床活动用时与住院天数更短,对比于B组后差异有统计学意义(P<0.05)。A组术后不良反应发生率为10.26%,B组为33.33%,差异有统计学意义(χ^(2)=5.940,P=0.015)。A组的肺不张概率为2.56%,静脉血栓概率为2.56%,肺部感染概率为0.00%,呼吸衰竭概率为2.56%,并发症发生率总计7.69%;B组的肺不张率为11.11%,静脉血栓率为11.11%,肺部感染率为2.78%,呼吸衰竭率为5.56%,并发症发生率总计30.56%,差异有统计学意义(χ^(2)=6.445,P=0.011)。结论在肺癌VATS疼痛管理期间将护士作为主体实行多学科合作可显著改善静息或是运动状态下的疼痛度,缩短胸腔引流与下床活动时间,且住院周期更短,术后的安全效益更佳。

Objective To analyze the value of multidisciplinary cooperation with nurses as the main body during lung cancer thoracoscopic surgery(VATS).Methods The subject of this study was selected conveniently 75 patients with lung cancer VATS who came to the hospital for treatment from October 2018 to May 2020.Based on the random method,39 cases were in group A,and nurses were the subject of multidisciplinary cooperation during pain management;36 cases were in group B,and routine pain management was implemented.Compared the effect of pain improvement.Results The pain scores of group A were lower at each time point in the resting and exercise state;the time of chest drainage,the time to get out of bed,and the length of hospital stay in group A were shorter,compared with group B,the difference was statistically significant(P<0.05).After the data were summarized in group A,the postoperative adverse reaction rate was 10.26%,and group B was 33.33%,the difference was statistically significant(χ^(2)=5.940,P=0.015).The probability of atelectasis in group A was 2.56%,the probability of venous thrombosis was 2.56%,the probability of lung infection was 0.00%,the probability of respiratory failure was 2.56%,and the total complication rate was 7.69%;the rate of venous thrombosis in group B was 11.11%,the rate of venous thrombosis was 11.11%,the rate of pulmonary infection was 2.78%,the rate of respiratory failure was 5.56%,and the total complication rate was 30.56%,the difference was statistically significant(χ^(2)=6.445,P=0.011).Conclusion During the period of lung cancer VATS pain management,the practice of multidisciplinary cooperation with nurses as the main body can significantly improve the pain in resting or exercise state,shorten the time of chest drainage and getting out of bed,and shorten the hospitalization period,and the postoperative safety benefits are better.