情志护理联合耳穴压豆对骨科大手术术后疼痛的影响

Clinical Observation on Effect of Emotional Nursing Combined with Auricular Acupoint Pressing with Beans on Postoperative Pain of Major Orthopedic Surgery

目的:观察在常规术后护理和镇痛的基础上采用情志护理联合耳穴压豆对骨科大手术术后疼痛的影响。方法:将128例患者随机分为对照组和观察组各64例。2组均予硬膜外自控镇痛泵48 h,并给予常规护理措施,观察组加用情志护理联合耳穴压豆。连续干预7天。记录术后1~3天的呼吸监测结果 (呼吸频率,血氧饱和度)、不良反应情况(恶心、呕吐评分,镇静评分),每天记录疼痛数字评分法(NRS)评分。评价患者的焦虑情况、睡眠质量和护理满意度。结果:术后1~3天,2组呼吸频率逐渐下降、血氧饱和度逐渐升高,镇静评分逐渐降低(P <0.01),恶心、呕吐评分均下降(P <0.01),观察组术后第2、3天的恶心、呕吐评分均低于对照组(P <0.01)。术后第2天,2组NRS评分均较术后1天下降,但在第3天因停用镇痛泵,NRS评分又开始升高。术后第5、7天,2组NRS评分逐渐降低(P <0.01),观察组术后3、5、7天的NRS评分均低于对照组(P <0.01)。干预7天后,观察组焦虑自评量表评分和睡眠质量评分均低于对照组(P <0.05)。观察组的睡眠质量优于对照组(P <0.01),疼痛程度轻于对照组(P <0.05),护理满意度高于对照组(P <0.05)。结论:在常规术后护理和镇痛的基础上采用中医情志护理联合耳穴压豆,能进一步减轻骨科大手术术后疼痛,减轻镇痛药物的恶心、呕吐等不良反应,减轻患者的焦虑程度,改善睡眠质量,提高患者对护理措施的满意度。

Objective:To observe the effect of emotional nursing combined with auricular acupoint pressing with beans based on routine postoperative nursing and analgesia on postoperative pain of major orthopedic surgery.Methods:A total of128 cases of patients were randomly divided into the control group and the observation group,64 cases in each group.Both groups were given patient-controlled epidural analgesia pump for 48 hours and routine nursing measures.The observation group was additionally treated with emotional nursing combined with auricular acupoint pressing with beans.The intervention lasted for seven days.The results of respiratory monitoring(respiratory rate and blood oxygen saturation)and the adverse reactions(the scores of nausea as well as vomiting and the score of sedation)one to three days after surgery,as well as the score of Numerical Rating Scale(NRS)per day were recorded.The anxiety,sleep quality and nursing satisfaction of patients were evaluated.Results:During the first three days after surgery,the respiratory rate in the two groups was gradually decreased,while the blood oxygen saturation was gradually increased,the scores of sedation were gradually decreased(P<0.01),the scores of nausea and vomiting were decreased(P<0.01).On the 2nd and 3rd day after surgery,the scores of nausea and vomiting in the observation group were lower than those in the control group(P<0.01).On the 2nd day after surgery,the scores of NRS in the two groups were decreased when compared with those one day after surgery,but began to increase on the 3rd day because of discontinuation of analgesia pump.On the 5th and 7th day after surgery,the scores of NRS in the two groups were gradually decreased(P<0.01);on the 3rd,5th and 7th day after surgery,the ones in the observation group were lower than those in the control group(P<0.01).After seven-day intervention,the scores of Self-Rating Anxiety Scale and sleep quality in the observation group were lower than those in the control group(P<0.05).The sleep quality in the observation group was superior to that in the control group(P<0.01),the degree of pain was lighter than that in the control group(P<0.05),and the nursing satisfaction was higher than that in the control group(P<0.05).Conclusion:The therapy of emotional nursing of Chinese medicine combined with auricular acupoint pressing with beans based on routine postoperative nursing and analgesia can further alleviate the postoperative pain of major orthopedic surgery,adverse reactions of analgesic medicine such as nausea and vomiting,and the anxiety of patients,and improve the sleep quality as well as nursing satisfaction.