意向放松训练在胸腔镜肺叶切除术后静脉自控镇痛泵患者中的应用

Application of intentional relaxation training in patients with patient-controlled intravenous analgesia pump after thoracoscopic lobectomy

目的探讨意向放松训练在胸腔镜肺叶切除术后静脉自控镇痛泵(PCIA)患者中的应用价值。方法按照随机数字表法纳入2020年2月至2021年3月上海交通大学医学院附属新华医院收治的100例胸腔镜肺叶切除术后PCIA患者,分为两组,每组各50例。对照组采用常规护理,观察组采用常规护理+意向放松训练。比较两组术后12、24、48 h镇静(Ramsay评分)、镇痛[视觉模拟评分法(VAS)评分]情况。评估两组术前、术后48 h焦虑程度[焦虑自评量表(SAS)评分],比较两组术后48 h时护理满意度。结果两组VAS、Ramsay评分时间、组间、交互作用比较,差异有统计学意义(P<0.05)。其中,组内比较,两组术后24、48 h VAS、Ramasy评分低于术后12 h,术后48 h低于术后24 h,差异有统计学意义(P<0.05);组间比较,观察组术后24、48 h VAS、Ramasy评分低于对照组,差异有统计学意义(P<0.05)。两组术后48 h SAS评分低于术前2 h,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组术后48 h时护理总满意度高于对照组,差异有统计学意义(P<0.05)。结论意向放松训练可增强胸腔镜肺叶切除术后PCIA患者的镇静镇痛效果,提高患者的护理满意度,改善焦虑状况。

Objective To investigate the application value of intentional relaxation training in patients with patient-controlled intravenous analgesia(PCIA)after thoracoscopic lobectomy.Methods According to the random number table method,a total of 100 patients with PCIA after thoracoscopic lobectomy who were admitted to Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from February 2020 to March 2021 were divided into two groups,with 50 cases in each group.The control group received routine nursing,while the observation group received routine nursing plus intentional relaxation training.The sedation(Ramsay score)and analgesia(visual analog scale[VAS]score)were compared between the two groups at 12,24,and 48 h after operation.The anxiety level(self-rating anxiety scale[SAS]score)was evaluated before and 48 h after operation in the two groups,while nursing satisfaction was compared between the two groups 48 h after operation.Results There were statistically significant differences in VAS,Ramsay score time,between groups,and interaction between the two groups(P<0.05).Among them,within the group comparison,the VAS and Ramasy scores of the two groups at 24 and 48 h after operation were lower than those at 12 h after operation,and the scores 48 h after operation were lower than those at 24 h after operation,and the differences were statistically significant(P<0.05);compared between groups,the VAS and Ramasy scores of the observation group at 24 and 48 h after operation were lower than those of the control group,and the differences were statistically significant(P<0.05).The SAS score at 48 h after operation in the two groups was lower than that at two hours before operation,while the observation group was lower than that in the control group,and the differences were statistically significant(P<0.05).The total nursing satisfaction of the observation group was higher than that of the control group at 48 h after operation,and the difference was statistically significant(P<0.05).Conclusion Intentional relaxation training can enhance the sedative and analgesic effect of PCIA patients after thoracoscopic lobectomy,improve patients’nursing satisfaction,and improve anxiety.