冰敷标准化作业联合穴位按摩护理对三叉神经痛患者术后疼痛及肿胀的影响

Effects of Standardized Ice Compress Jointed with Acupoint Massage on Postoperative Pain and Swelling in Patients with Trigeminal Neuralgia

目的:观察冰敷标准化作业联合穴位按摩护理对三叉神经痛患者术后疼痛及肿胀的影响。方法:将80例行射频热凝联合阿霉素注射治疗的三叉神经痛患者随机分为观察组和对照组,每组40例。对照组术后予常规冰敷干预;观察组术后予标准化冰敷干预联合穴位按摩护理。术后1、2、3天时评估患者头面部肿胀程度、疼痛视觉模拟评分(visual analogue score,VAS),术后3天评估患者舒适度,记录术后并发症,比较术后住院时间和住院费用。结果:术后1、2、3天时,观察组头面部肿胀程度均轻于对照组(P<0.05)。术后1、2、3天时,观察组VAS评分均低于对照组(P<0.05)。观察组Kolcaba舒适状况量表各指标评分及总评分均明显高于对照组(P<0.05)。两组颌面部麻木、咬肌肌力下降、流口水、角膜麻痹、头痛、恶心呕吐等单个并发症的发生率比较,差异无统计学意义(P>0.05),但并发症总发生率观察组低于对照组,差异有统计学意义(P<0.05)。观察组住院时间及住院费用均少于对照组(P<0.05)。结论:冰敷标准化作业联合穴位按摩护理可明显减轻射频热凝联合阿霉素治疗三叉神经痛后的头面部肿胀、疼痛程度,增加舒适度,减少术后并发症和住院费用。

Objective: To observe the influence of standardized ice compress jointed with acupoint massage on postoperative pain and swelling in patients with trigeminal neuralgia. Methods: Eighty patients treated by radiofrequency thermocoagulation and adriamycin injection were randomized into the observation group and the control group, 40 cases in each group. The control group were intervened by conventional ice compress after the surgery;the observation group accepted standardized ice compress and acupoint massage. To evaluate swelling degrees of head and face, VAS on the first, second and third day after the operation, and assess the patients’ comfort degrees on the third day after the surgery, to record postoperative complications, to compare postoperative hospitalization duration and hospitalization cost. Results: One, two and three days after the operation, the swelling degrees of head and face in the observation group were lighter than these of the control group(P<0.05). One, two and three days after the operation, VAS scores of the observation group were lower than these of the control group(P<0.05). The scores of different items of Kolcaba general comfort questionnaire of the observation group were remarkably higher than these of the control group(P<0.05). The difference showed no statistical meaning in the incidence of single complication such as maxillofacial numbness, masseter muscle strength decreased, drooling,corneal paralysis, headache, nausea and vomiting between both groups(P>0.05), while the overall incidence of the complications of the observation group was lower than that of the control group, and the difference was statistically significant(P<0.05). The observation group was lower than the control group in hospitalization time(P<0.05),less than the control group in hospitalization expense(P<0.05). Conclusion: Standardized ice compress jointed with acupoint massage could obviously relieve the swelling degrees of head and face, as well as pain degrees in patients with trigeminal neuralgia who were treated by radiofrequency thermocoagulation and adriamycin injection,raise comfort degrees, and reduce postoperative complications and hospitalization expense.