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。
Objective： To investigate the post-operative pain status in patients undergoing PCNL, in order to provide a ref- erence 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 seore of pain in the first section was the highest [（4.26±1.46） scores]; there were 85 patients （67.5%） experienced the most severe pain scored more than 4 during the first seetion; the most severe pain oeeurred at （4.81±2.22） hours after operation in the first seetion and the dull pain in surgieal site was most popular. In the first seetion 47.62% of patients used analgesics and the analgesics were used at （6.51±2.63） hours after operation. The pain scores in the second, the third and the fourth seetion were （2.39±1.21）, （2.08±1.02）, （1.86±0.32） respectively, and the pain caused by stretching the drainage tube, the pain eaused by removing the drainage tube and the pain in the affected lumbago were popular during those sections. There was a significant difference in the pain scores among four post-operative section （F=3.57, P=0.04）. Conclusion： The overall pain beliefs of patients with PCNL are negative, and the post-operative pain is serious symptom among patients with PCNL. The pain management should be improved and effective measures should be taken according to the characteristic of the pain.
出处
《中国医药导报》
CAS
2011年第32期146-148,共3页
China Medical Herald
作者简介
王爱松（1978-），女，河南郑州人，本科，主管护师，主要从事泌尿外科的微创手术护理工作。
