护理干预对外科手术术后疼痛相关性探究.docVIP

护理干预对外科手术术后疼痛相关性探究作者单位：514011 广东省梅县人民医院 通讯作者：王雪梅 【摘要】 目的 探讨护理干预对外科手术术后疼痛的方法和疗效。方法 回顾性分析笔者所在医院外科收治的126例手术患者的病例资料，所有患者随机分为两组，对照组63例患者应用常规疼痛的护理方法，治疗组63例患者在对照组的基础上进行心理护理、健康宣教等认知、心理、行为的护理干预。并对两组患者在手术后第1、3、7天的术后疼痛采用NRS法进行评分。结果 两组术后疼痛对比结果显示，治疗组疼痛评分明显低于对照组，差异有统计学意义（P＜0.05）。结论 对外科手术患者进行护理干预可明显减轻患者的术后疼痛指数，利于患者早期康复。 【关键词】 护理干预； 外科手术； 术后疼痛 Correlative study on nursing intervention on postoperative pain after surgery WANG Xue-mei.People’s Hospital of Mei town in Guangdong，Mei town 514011，China 【Abstract】 Objective To investigate the method and effect of the nursing intervention on postoperative pain after surgical.Methods A retrospective analysis of data of 126 cases patients who were treated in the surgery of our hospital, all patients were randomly divided into two groups, 63 patients in the comparison group had been offered by nursing of the conventional pain-care, on the basis of that,the other 63 patients in treatment group resorted to the cognitive, psychological or behavioral nursing intercentions, such as psychological nursing, health education and so on. Moreover, Using the NRS method to do an assessment for patients of their postoperative pain in the two groups on the first,third or seventh day after surgery.Results After contrast on the extent of postoperative pain,it showed that the treatment group was significantly lower than the comparison group, and the difference between them was apparent, and it had a statistically significance （P 3 讨论 术后切口发生疼痛可致患者的机体出现应激反应，增加组织分解代谢机能，其对患者手术切口的愈合有很大的影响。疼痛能够刺激患者体内肾上腺素、组胺、缓激肽等介质 表1 两组术后疼痛NRS评分（x±s） 注：与对照组比较，*u7.0279，P0.0000；△u30.7636，P0.0000；＃u35.4965，P0.0000 释放增多，引起中枢性神经递质的代谢失衡。而进行术后镇痛可以让应激反应下降，让致痛的物质儿茶酚胺、皮质醇等明显降低，从而减轻患者的疼痛。有报道称我国各级医院外科手术患者的术后疼痛都没有得到及时的治疗［4］。而过往的术后护理多使用镇痛药物进行术后镇痛，但其效果不是很理想，会因患者的体位、紧张心理、下床活动、咳嗽、咳痰等因素降低镇痛疗效。有文献报道称术后疼痛除受手术部位、创伤大小等客观因素的影响外，还取决于患者的情绪、精神、心理状态等主观因素的影响［5］。给予患者心理干预可舒缓患者的紧张情绪，术后的疼痛指数明显下降。故给予患者术后进行心理护理工作很重要［6～8］。 本研究对治疗组患者进行术后疼痛的护理干预，在常规护理的基础上应用心理护理、健康宣教等认知、心理、行为的护理干