CAJ | 학술논문

目的：探讨应用硬膜外持续镇痛联合镇静催眠综合干预睡眠障碍与疼痛对促进腹部术后患者康复的作用。方法便利选取2011年12月至2012年11月东阳市中医院外科收治的40例腹部手术患者，按随机数字表法分为对照组和观察组各20例，观察组术后采取硬膜外持续镇痛联合镇静催眠，对照组仅给予硬膜外持续镇痛。比较两组患者的术后睡眠时间、匹兹堡睡眠质量指数（Pittsburgh sleep quality index，PSQI）、疼痛评分、疲乏及营养状况，以及并发症发生情况。结果研究组患者术后平均睡眠时间长于对照组，术后1周 PSQI、心理、躯体、精神及平均疲劳程度、营养状况评分均低于对照组，术后第1、3天疼痛评分低于对照组，差异均有统计学意义（P ＜0．05）。研究组术后未出现任何并发症，对照组有3例（15％）患者出现术后并发症，差异有统计学意义（P ＜0．05）。结论对腹部术后患者进行睡眠障碍及疼痛的综合干预可减轻患者疼痛和疲劳程度，改善睡眠质量及营养状况，减少术后并发症的发生。
목적：탐토응용경막외지속진통연합진정최면종합간예수면장애여동통대촉진복부술후환자강복적작용。방법편리선취2011년12월지2012년11월동양시중의원외과수치적40례복부수술환자，안수궤수자표법분위대조조화관찰조각20례，관찰조술후채취경막외지속진통연합진정최면，대조조부급여경막외지속진통。비교량조환자적술후수면시간、필자보수면질량지수（Pittsburgh sleep quality index，PSQI）、동통평분、피핍급영양상황，이급병발증발생정황。결과연구조환자술후평균수면시간장우대조조，술후1주 PSQI、심리、구체、정신급평균피로정도、영양상황평분균저우대조조，술후제1、3천동통평분저우대조조，차이균유통계학의의（P ＜0．05）。연구조술후미출현임하병발증，대조조유3례（15％）환자출현술후병발증，차이유통계학의의（P ＜0．05）。결론대복부술후환자진행수면장애급동통적종합간예가감경환자동통화피로정도，개선수면질량급영양상황，감소술후병발증적발생。
Objective To explore the effect of sleep disorders and pain by continuous epidural analgesia intervention and continuous bilateral intervention with sedative hypnotic drug on recovery of patients after abdominal operation.Methods By convenience sampling,40 patients with abdominal surgical operation were selected and equally divided into the control group and the observation group.20 cases in the control group received continuous epidural analgesia,while 20 cases of the observation group received continuous epidural analgesia combined with sedative and hypnotic.The sleep time,Pittsburgh sleep quality index (PSQI),pain score,fatigue and nutrition status and the postoperative complications were observed.Results The average sleep time of the experimental group was longer than the control group.The PSQI, psychological fatigue,physical fatigue,mental fatigue and fatigue on average scores and nutrition status in experimental group were lower than which in control group of 1 week after operation.The pain scores of the experiment group after operation 1d and 3d were lower than those of the control group (P <0.05). There was no postoperative complication showed in experimental group,while 3 cases (15%)had post-operative complication in control group (P <0.05).Conclusion For patients after abdominal operation with bilateral intervention could reduce the pain and fatigue,improve sleep quality,nutrition status and reduce patient complications.