围手术期疼痛专项护理联合静脉镇痛在慢性鼻窦炎手术患者中的应用价值

To explore the application value of perioperative pain special nursing combined with intravenous analgesia in patients with chronic sinusitis surgery

目的 探讨围手术期疼痛专项护理联合静脉镇痛在慢性鼻窦炎手术患者中的应用价值。方法 选择择期慢性鼻窦炎手术女性患者60例,采用随机数字表法将患者分为三组,每组20例,A组患者给予常规性护理同时在手术前给予静脉镇痛(艾司氯胺酮持续输注至手术结束前15min);B组患者在常规护理基础上增加围术期疼痛专项护理同时在手术前给予生理盐水持续输注至手术结束前15min;C组患者在常规护理基础上增加围术期疼痛专项护理同时在手术前给予静脉镇痛(艾司氯胺酮持续输注至手术结束前15min)。记录三组患者术后6h、24h、72h(拔除鼻腔填塞物时)及出院时视觉模拟疼痛评分(visual analogue scale/score, VAS);三组患者护理前及护理后的心理状态评分(焦虑自评量表Self-Rating Anxiety Scale, SAS、抑郁自评量表Self-rating depression scale, SDS);头晕、头痛、恶心、眶周淤血等不良反应的发生情况。结果 C组患者术后6h、24h、72h(拔除鼻腔填塞物时)及出院时VAS评分明显低于A组和B组患者(P<0.05),C组患者术后焦虑(SAS)与抑郁(SDS)评分明显低于A组和B组患者(P<0.05)。A组和B组患者在不同时间点VAS评分、SAS与SDS评分差异无统计学意义(P>0.05)。不良反应发生率A、B、C分别为45%、35%、10%,具有统计学意义(P<0.05)。结论 慢性鼻窦炎患者行鼻内镜手术治疗中实施疼痛专项护理联合静脉镇痛干预可有效疏导患者不良情绪,减轻术后疼痛,促进术后康复,且减少术后不良反应发生率,值得临床推广。

Objective To explore the application value of perioperative pain special nursing combined with intravenous analgesia in patients with chronic sinusitis.Methods Sixty female patients undergoing elective chronic sinusitis surgery were selected and were randomly divided into three groups,20 cases in each group.Patients in group A were given routine nursing and intravenous analgesia before surgery(continuous infusion of esketamine until 15 minutes before the end of surgery).On the basis of routine nursing,patients in group B were given perioperative pain special nursing and normal saline continuous infusion until 15 minutes before the end of surgery.Patients in group C were given perioperative pain special nursing on the basis of routine nursing and intravenous analgesia before surgery(continuous infusion of esketamine until 15 minutes before the end of surgery).The visual analogue scale/score(VAS)was recorded at 6h,24h,72h(at the time of nasal packing removal)after surgery and and at discharge.The psychological state scores of the three groups before and after nursing(Self-Rating Anxiety Scale,SAS,Self-rating depression scale,SDS);The occurrence of adverse reactions such as dizziness,headache,nausea and Periorbital hematoma was analyzed.Results The VAS scores of patients in group C at 6h,24h,72h(at the time of nasal packing removal)after surgery and at discharge after operation were significantly lower than those in group A and group B(P<0.05).The SAS and SDS scores of patients in group C were significantly lower than those in group A and group B(P<0.05).There was no significant difference in VAS score,SAS and SDS score between group A and group B at different time points(P>0.05).The incidence of adverse reactions in A,B,and C were 45%,35%,and 10%,respectively,with statistically significant differences(P<0.05).Conclusion The implementation of special pain nursing combined with intravenous analgesia intervention in the treatment of chronic sinusitis patients with endoscopic sinus surgery can effectively relieve patients'bad emotions,reduce postoperative pain,promote postoperative rehabilitation,and reduce the incidence of postoperative adverse reactions,which is worthy of clinical promotion.