路径化管理对胃癌手术患者疼痛的影响.doc

路径化管理对胃癌手术患者疼痛的影响 【摘要】目的：研究路径化管理对胃癌患者术前和术后疼痛的影响。方法： 选取2011年3月?2014年12月本院确诊的胃癌并伴有癌痛患者90例作为研 究对象,按照是否进行路径化管理分为对照组和观察组,每组45例。对照组进 行一般常规护理，仅根据患者疼痛程度给予镇痛治疗，观察组在对照组基础上由 专门成立路径化管理小组统一管理。比较两组患者疼痛依从性、术前、术后3 d 疼痛评分、护理工作满意度情况。结果：观察组在疼痛依从性、术前1氏术后 前3 d疼痛评分及护理工作满意度方面均优于对照组上匕较差异均有统计学意义 (Pv0.05 )。结论：对胃癌患者实施路径化管理z有助于患者术后疼痛的缓解 和康复。 【关键词】路径化管理；胃癌；疼痛；临床 [Abstract】 Objective : To study the effect of path management on the preoperative and postoperative pain of patients with gastric cancer.Method : From March 2011 to December 2014,90 cases of diagnosis gastric cancer combined with cancer pain in our hospital were selected as the research objects , they were divided into the control group and the observation group according to whether carry on path management z each group had 45 cases.The control group were given routine nursing care and treated with analgesic therapy according to the degree of pain in patients z the observation group was set up by the specialized management group on basis of the control group.The pain complianee z preoperative and postoperative 3 d pain score , nursing job satisfaction in two groups were compared.Result :The observation group was better than the control group in terms of pain complianee z preoperative 1 d and the first 3 d after operation pain score and the nursing job satisfaction , the differences were statistically significant (P0.05 ) .Conelusion : The implementation of path management for patients with gastric cancer is helpful for postoperative pain relief and rehabilitation of patients. [Key words] Path ma nageme nt; Gastric ca ncer; Pain ; Clinical 胃癌是病死率极高的恶性肿瘤之一，我国胃癌呈逐年上升趋势[1]。疼痛是 癌症患者常见的伴随症状之一，可能出现在整个病程任意时段，是癌症患者自觉 症状中发生率最高也是最令患者痛苦的症状[2]。2002年第十届国际疼痛大会提 出：疼痛已成为继体温、血压、呼吸、脉搏四大生命体征之后的第五大生命体征 [3]o胃癌手术患者疼痛不仅给患者造成一定的痛苦，还会引起各个器官的生理 功能紊乱，对机体的恢复造成损害,对患者的预后造成影响,减轻疼痛有利于提 高患者的生活质量和生活进度，为患者消除疼痛是每个医护人员的重中之重。伴 随着路径化管理在临床诊断中的全面实施，术后患者的疼痛问题成为路径化管理 的重要部分。路径化管理是由医疗保健的一组成员根据不同的临床疾病或手术方 法，制定岀最恰当、最有时间性、顺序性的医疗及护理模式。本院根据胃癌手术 患者疼痛的特点，制定了胃癌手术患者疼痛治疗的管理路径表，将其应用于临床 中,旨在减