个体化疾病认知管理联合超前镇痛在巨大肩袖损伤手术患者中的应用

Application of the individualized disease perception management plus preemptive analgesia for patients with massive rotator cuff injuries

目的:探讨个体化疾病认知管理联合超前镇痛在巨大肩袖损伤手术患者中的应用效果。方法:选取2020年6月~2022年4月在阜阳市人民医院行关节镜修复术的巨大肩袖损伤患者52例为研究对象,其中2020年6月~2021年4月的26例患者为对照组,2021年5月~2022年4月的26例患者为研究组。对照组实施常规护理,研究组在此基础上给予个体化疾病认知管理联合超前镇痛干预,比较两组术后功能锻炼依从性及手术前后肩关节功能Constant-Murley评分、疼痛视觉模拟评分(VAS)、焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分,评价应用效果。结果:研究组术后功能锻炼依从性高于对照组(P<0.05);两组患者术后6个月Constant-Murley评分较术前升高,SAS评分、SDS评分较术前降低(P<0.05);且研究组术后6个月SAS评分、SDS评分下降幅度均优于对照组(P<0.05)。两组术后3周、6个月VAS评分较术前均有下降(P<0.05),且研究组术后3周、6个月VAS评分低于对照组(P<0.05)。结论:个体化疾病认知管理联合超前镇痛有利于提高巨大肩袖损伤手术患者功能锻炼依从性,改善肩关节功能,缓解焦虑抑郁情绪,减轻其疼痛,促进患者康复。

Objective:To observe the clinical efficacy of individualized disease perception management combined with preemptive analgesia for patients with massive rotator cuff injuries.Methods:Fifty-two patients with massive rotator cuff tear undergone arthroscopic repair in our hospital were included from June 2020 to April 2022.Patients treated during June 2020 and April 2021 were allocated to control group(n=26),and those treated between May 2021 and April 2022 were included in observational group(n=26).Patients in control group just received conventional care,and those in the study group were given individualized disease perception management plus preemptive analgesia.The two groups were compared regarding the compliance with postoperative functional exercise,scores on Constant-Murley Scale for shoulder function,Visual Analogue Scale(VAS),Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS)before and after operation to evaluate the efficacy.Results:Postoperative functional exercise compliance was higher in the observational group than in the control group(P<0.05).The scores on Constant-Murley Scale were higher,yet the scores on SAS and SDS were lower at the 6 th month after surgery compared to those before operation(P<0.05).Improvement in the scoring on SAS and SDS was better in the observational group than in control group by the 6 th month following surgery(P<0.05).The decrease on VAS was significant in both groups,yet was more notable in the observational group than in the control group at the 3 rd week and 6 th month compared to pre-operation(P<0.05).Conclusion:Individualized disease perception management plus preemptive analgesia applied for the patients with massive rotator cuff injuries following surgery can improve the compliance with postoperative functional exercise and shoulder function,reduce anxiety,depression and pain,and promote early recovery of this group of patients.