摘要
目的探讨超前镇痛护理理念对食管癌患者术后疼痛控制的影响。方法随机将188例食管癌手术患者分为常规镇痛组(n=93)和超前镇痛组(n=95)。常规镇痛组实施常规镇痛护理,即术前行疼痛知识宣教,术后应用Prince-Henry评分法定时评估患者疼痛,根据评分行针对性镇痛护理;超前镇痛组实施超前镇痛护理,即在前者基础上增加术前超前镇痛知识宣教,术后在执行各临床操作前行预见性疼痛评估,根据评分行预见性镇痛处理。比较两组患者术后24h、48h、72h疼痛评分,术后首次下床活动时间,肺部并发症发生率。结果两组术后24h、48h、72h疼痛评分比较,干预主效应P<0.05;超前镇痛组下床活动时间较常规镇痛组显著提前,肺部并发症发生率显著低于常规镇痛组(P<0.05,P<0.01)。结论超前镇痛护理理念对食管癌患者术后疼痛控制有积极的作用,有利于患者早日康复。
Objective To discuss the effects of preemptive analgesia on postoperative pain control for esophageal cancer patients.MethodsTotally,188 esophageal cancer patients were divided into a routine analgesia group（n=93） and a preemptive analgesia group（n=95）.The routine analgesia group were given routine preoperative education of pain,and nursing care according to postoperative pain assessment with Prince-Henry score.The preemptive analgesia group additionally received preemptive analgesia education,and predictive pain management： pain was assessed before every clinical or nursing procedure,and analgesics were given to patients according to the assessment scores.Comparison was made between the two groups in terms of pain severity at postoperative 24 h,48 h and 72 h,time to start postoperative ambulation,and pulmonary complications.ResultsThe group effect of intervention had significant difference in severity of pain at postoperative 24 h,48 h and 72 h（P〈0.05）.The preemptive analgesia group had significantly earlier ambulation and lower pulmonary complications than the routine analgesia group（P〈0.05,P〈0.01）.ConclusionPreemptive analgesia exerts positive effects on postoperative pain control for esophageal cancer patients,and is beneficial for patients′ early rehabilitation.
基金
2008年湖北省自然科学基金项目(2008CDB227)
关键词
食管癌手术
急性疼痛
超前镇痛
护理理念
疼痛控制
esophageal cancer operation
acute pain
preemptive analgesia
nursing philosophy
pain control
