CAJ | 학술논문

目的：开胸手术由于创伤大，术后疼痛剧烈，会引起患者诸多心理和生理的应激反应，严重影响疾病治疗的转归及功能恢复。文中通过回顾性分析开胸手术患者术后疼痛和护理干预的相关性，评估护理干预对减轻术后疼痛的影响。方法收集2013年12月至2014年3月南京军区南京总医院心胸外科580例开胸手术患者的护理资料，将术后疼痛时间分为4期：第1期为麻醉清醒至24 h内，第2期为术后第2天，第3期为术后第3天，第4期为术后第4天后；采用危重症患者疼痛观察工具（ the critical care pain observation tool ， CPOT）和五指疼痛评估法进行各期疼痛评估并采取相应的干预措施，分析患者接受镇痛、雾化吸入、导管护理、体位护理、环境干预、心理干预等护理措施后的效果。结果对于患者不同时期的疼痛采用不同的护理干预措施后，术后疼痛评分逐期降低，第1－4期分别为（2．89±0．39）分、（2．25±0．90）分、（1．58±0．57）分、和（1．06±0．24）分。两两比较的差异均有统计学意义（P＜0．01）。结论根据术后疼痛分期对患者疼痛采取综合护理干预措施能有效缓解开胸手术后患者的疼痛程度。
목적：개흉수술유우창상대，술후동통극렬，회인기환자제다심리화생리적응격반응，엄중영향질병치료적전귀급공능회복。문중통과회고성분석개흉수술환자술후동통화호리간예적상관성，평고호리간예대감경술후동통적영향。방법수집2013년12월지2014년3월남경군구남경총의원심흉외과580례개흉수술환자적호리자료，장술후동통시간분위4기：제1기위마취청성지24 h내，제2기위술후제2천，제3기위술후제3천，제4기위술후제4천후；채용위중증환자동통관찰공구（ the critical care pain observation tool ， CPOT）화오지동통평고법진행각기동통평고병채취상응적간예조시，분석환자접수진통、무화흡입、도관호리、체위호리、배경간예、심리간예등호리조시후적효과。결과대우환자불동시기적동통채용불동적호리간예조시후，술후동통평분축기강저，제1－4기분별위（2．89±0．39）분、（2．25±0．90）분、（1．58±0．57）분、화（1．06±0．24）분。량량비교적차이균유통계학의의（P＜0．01）。결론근거술후동통분기대환자동통채취종합호리간예조시능유효완해개흉수술후환자적동통정도。
Objective Because of the major trauma from thoracotomy , postoperative pain may arouse patients'psychological and physiological stress response and hence affected the treatment outcome and functional recovery seriously .We retrospectively studied the correlation between the staging of pain and nursing interference to investigate the effect of nursing interference on the pain intensity after thoracic surgery . Methods Five hundred and eighty cases of patients surviving thoracotomy between December 2013 and March 2014 in Nanjing Jingling Hospital were reviewed .Correlations between comfortable nursing measures such as effective analgesia , postural care , catheter care , environmental interventions , psychological intervention and the standard assessment of pain were analysed according to postoperative pain stage . Results With comprehensive nursing interference , the highest pain score occurred in the first 24 hour (2.89 ±0.39).The score was reduced gradually to 2.25 ±0.90 in stage Ⅱ, 1.58 ±0.57 in stage Ⅲ and 1.06 ±0.24 in stage Ⅳrespectively . Conclusion Comprehensive nursing interference according to pain staging may relieve pain effectively after thoracotomy .