CAJ | 학술논문

目的：探讨无痛病房管理模式对肝癌患者围术期疼痛控制及术后恢复的影响。方法选取2013年在我科住院行手术切除的原发性肝癌患者182例，将其随机分为对照组（85例）和观察组（97例）。对照组患者给予传统的疼痛管理模式，观察组患者给予无痛病房管理模式。比较两组患者术后下床活动时间、肠道通气时间、夜间睡眠时长、住院时间、并发症发生率及疼痛控制满意度间的差异。结果观察组术后下床活动时间、肠道通气时间、住院时间分别为（1.82±0.41）、（1.83±0.52）、（9.74±1.42）d，均低于对照组的（3.01±0.62）、（2.72±0.81）、（12.83±2.92）d（P<0.05），而夜间睡眠时长则较对照组延长〔（7.4±0.8）h与（5.7±0.7）h，P<0.05〕。术后观察组并发症发生率为12.4%（12/97），与对照组的17.6%（15/85）比较无差异（P>0.05）。观察组对疼痛控制不满意6例（6.2%），满意61例（62.9%），非常满意30例（30.9%）；对照组对疼痛控制不满意42例（49.4%），满意38例（44.7%），非常满意5例（5.9%），观察组疼痛控制满意度优于对照组（ P<0.05）。结论无痛病房管理模式在肝癌围术期的应用不仅缩短了患者术后下床活动时间、肠道通气时间及住院时间，延长了术后夜间睡眠时长，还提高了患者对住院期间疼痛控制的满意度，有效改善了患者围术期的生活质量，促进了患者早日康复。
목적：탐토무통병방관리모식대간암환자위술기동통공제급술후회복적영향。방법선취2013년재아과주원행수술절제적원발성간암환자182례，장기수궤분위대조조（85례）화관찰조（97례）。대조조환자급여전통적동통관리모식，관찰조환자급여무통병방관리모식。비교량조환자술후하상활동시간、장도통기시간、야간수면시장、주원시간、병발증발생솔급동통공제만의도간적차이。결과관찰조술후하상활동시간、장도통기시간、주원시간분별위（1.82±0.41）、（1.83±0.52）、（9.74±1.42）d，균저우대조조적（3.01±0.62）、（2.72±0.81）、（12.83±2.92）d（P<0.05），이야간수면시장칙교대조조연장〔（7.4±0.8）h여（5.7±0.7）h，P<0.05〕。술후관찰조병발증발생솔위12.4%（12/97），여대조조적17.6%（15/85）비교무차이（P>0.05）。관찰조대동통공제불만의6례（6.2%），만의61례（62.9%），비상만의30례（30.9%）；대조조대동통공제불만의42례（49.4%），만의38례（44.7%），비상만의5례（5.9%），관찰조동통공제만의도우우대조조（ P<0.05）。결론무통병방관리모식재간암위술기적응용불부축단료환자술후하상활동시간、장도통기시간급주원시간，연장료술후야간수면시장，환제고료환자대주원기간동통공제적만의도，유효개선료환자위술기적생활질량，촉진료환자조일강복。
Objective Toinvestigatetheeffectsofpainlesswardmanagementmodelonpaincontrolandpostoperative recoveryofpatientswithhepatocellularcarcinoma(HCC)duringperioperativeperiod.Methods 182patientswithHCCwhoun-derwent hepatectomy in our department were randomly divided into control group(85 cases)and observation group(97 cases). The patients in observation group underwent painless ward management model and those in control group underwent traditional pain management model. Time for get out of bed after surgery,postoperative intestinal exhaust time,duration of night sleep,duration of hospital stays,incidence of postoperative complication and satisfaction degree for pain-control were compared between two groupsofpatients.Results Thetimeforgetoutofbedaftersurgery,postoperativeintestinalexhausttimeanddurationofhospital stays in observation group were(1. 82±0. 41) d,(1. 83±0. 52) d and(9. 74±1. 42) d,respectively,which were signifi-cantly shorter than those in control group〔(3. 01 ±0. 62)d,(2. 72 ±0. 81)d,(12. 83 ±2. 92)d,respectively,P<0. 05〕;Duration of night sleep in observation group was(7. 4±0. 8)h,which was significantly longer than that(5. 7±0. 7)h in control group(P<0. 05). There was no significant difference in incidence of postoperative complication between observa-tion group〔12. 4%(12/97)〕and control group〔17. 6%(15/85)〕(P>0. 05). Satisfaction degree for pain-control in observation group:6(6. 2%)were not satisfied,61(62. 9%)were satisfied,30(30. 9%)were very satisfied;satisfaction degree for pain-control in control group:42(49. 4%)were not satisfied,38(44. 7%)were satisfied,5(5. 9%)were very satisfied. Satisfaction degree in observation group was significantly better than that in control group ( P<0. 05 ). ℅onclusion ApplicationofpainlesswardmanagementmodelforpatientswithHCCduringperioperativeperiodcanshortentimeforgetoutof bed after surgery,postoperative intestinal exhaust time and duration of hospital stays,prolong duration of night sleep,improve satisfaction degree for pain-control during hospitalization,effectively improve the quality of life of patients during perioperative period,and promote a soon recovery.