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专业疼痛管理对开胸手术患者术后疼痛及舒适度的影响

The impact of professional pain management in improving postoperative pain and comfort in patients undergoing thoracotomy surgery

    摘要
  • 摘要:
    目的  观察专业疼痛管理措施对开胸手术患者术后舒适度和疼痛的干预效果。
    方法  选取2018年3月—2021年3月在空军军医大学第二附属医院心胸外科实施开胸手术治疗的127例患者为研究对象，其中63例患者采用常规护理措施(常规组)，64例患者采用专业疼痛管理护理措施(研究组)，比较2组患者术后不同时点视觉模拟评分法(VAS)评分、舒适状况量表(GCQ)评分、患者镇痛自我管理行为评分。
    结果  研究组术后24、48、72、96 h的VAS评分均低于常规组，差异有统计学意义(P < 0.05)。研究组术后12 h的心理维度、环境维度、GCQ总分均高于常规组，术后72 h生理维度、心理维度、环境维度、GCQ总分均高于常规组，差异有统计学意义(P < 0.05)。研究组术后12 h的自我护理行为评分、治疗依从性评分、镇痛自我管理行为总分均高于常规组，术后72 h的疾病知识管理行为评分、自我护理行为评分、治疗依从性评分、镇痛自我管理行为总分均高于常规组，差异有统计学意义(P < 0.05)。研究组患者通过改变体位、转移止痛、按摩疗法缓解疼痛的占比高于常规组，差异有统计学意义(P < 0.05)。
    结论  开胸手术患者采用专业疼痛管理措施对于改善患者术后舒适度、减轻疼痛具有显著效果，值得临床推广应用。

     

    Abstract:
    Objective  To observe the effect of professional pain management measures on postoperative comfort and pain in patients undergoing thoracotomy.
    Methods  A total of 127 patients undergoing thoracotomy in the Department of Cardiothoracic Surgery of the Second Affiliated Hospital of Air Force Medical University from March 2018 to March 2021 were selected as research subjects, 63 patients received conventional nursing measures (conventional group) and 64 patients received professional pain management nursing measures (research group). The score of Visual Analog Scale (VAS), General Comfort Questionnaire (GCQ), and patient self-management behavior score were compared between the two groups at different time points after surgery.
    Results  The VAS scores of the research group at 24, 48, 72, and 96 hours after surgery were lower than those of the conventional group (P < 0.05). The psychological dimension, environmental dimension, and GCQ total score of the research group at 12 hours after surgery were higher than those of the conventional group, and the physiological dimension, psychological dimension, environmental dimension, and GCQ total score at 72 hours after surgery were higher than those of the conventional group (P < 0.05). The self-care behavior score, treatment compliance score, and analgesia self-management behavior score of the research group at 12 hours after surgery were higher than those of the conventional group, and the disease knowledge management behavior score, self-care behavior score, treatment compliance score, and analgesia self-management behavior score at 72 hours after surgery were higher than those of the conventional group (P < 0.05). The proportions of patients in the research group who alleviated pain by changing body position, transferring pain relief, and massage therapy were higher than those in the conventional group (P < 0.05).
    Conclusion  The use of professional pain management measures for patients undergoing thoracotomy has significant effects in improving patients' comfort and reducing pain after surgery, and is worthy of clinical application.

     

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