经皮肾镜取石术后患者疼痛状况调查.docVIP

经皮肾镜取石术后患者疼痛状况调查[摘要] 目的：调查经皮肾镜取石术后患者的疼痛状况，为术后进行有效疼痛管理提供依据。方法：采用视觉模拟标尺法（VAS）、疼痛及麻醉性镇痛药信念量表及自行设计的患者一般情况调查表对126例经皮肾镜取石术后患者进行调查，记录患者术后四个阶段内疼痛状况。结果：患者整体疼痛信念平均得分（2.90±0.26）分，以“麻醉性止痛药只应该被使用在疼痛剧烈时”和“麻醉性止痛药会引起许多副作用”两项平均得分最高，分别为（3.14±0.38）、（2.96±0.24）分；不同文化程度患者疼痛信念总分存在差异（F=4.45，P=0.02）。患者开始疼痛时间为术后（2.98±1.16）h，术后第一阶段疼痛程度最高，得分为（4.26±1.46）分，最严重时疼痛得分4分者85例（67.46%），疼痛最严重时间为术后（4.81±2.22）h，主要为手术部位钝痛，该阶段47.62%的患者使用镇痛剂，开始使用镇痛剂的时间为术后（6.51±2.63）h；第二阶段至第四阶段疼痛评分依次为（2.39±1.21）、（2.08±1.02）、（1.86±0.32）分，疼痛依次为牵拉引流管造成的疼痛、拔除肾引流管造成的疼痛、患侧腰部疼痛。术后四个阶段疼痛程度得分差异有统计学意义（F=3.57，P=0.04）。结论：经皮肾镜患者术后疼痛信念趋于负向，术后疼痛问题不容忽视，术后疼痛管理有待改善，应针对患者疼痛特点，实施有效疼痛管理。 [关键词] 疼痛；经皮肾镜取石术；数据收集 [中图分类号] R699.2；R473.6 [文献标识码] C [文章编号] 1673-7210（2011）11（b）-146-03 Investigation on the post-operative pain among patients with PCNL WANG Aisong1, CHENG Nianzhen2 1.Department of Urology, He′nan Traditional Chinese Medicine Hospital, Zhengzhou, 450002, China; 2.Department of Urology, the Affiliated Xiangya Hospital of Southern Middle University, Changsha 410008, China [Abstract] Objective: To investigate the post-operative pain status in patients undergoing PCNL, in order to provide a reference for effective post-operative pain management for patients with PCNL. Methods: A cross-section study was conducted in 126 patients who underwent PCNL with the VAS, Pain and Opioids Analgesics Beliefs scale and self-designed questionnaire. Results: The mean scores of pain beliefs of the patients undergoing PCNL was (2.90±0.26), and the items with highest scores of (3.14±0.38) and (2.96±0.24) were “opioids analgesics should be used only when in severe pain” and “opioids analgesics may cause many side effects”; and there were significant differences in pain beliefs among patients with different educational backgrounds (F=4.45, P=0.02). The pain occurred at (2.98±1.16) hours after operation; and among the four sections the score of pain in the first section was the highest [(4.26±1.46) scores]; there were 85 patients (67.5%) experienced