成人心脏外科术后疼痛调查  

INVESTIGATIONS OF PAIN IN ADULTS AFTER CARDIAC SURGERY

作　　者：安建雄[1] 李九妹 罗非[3] 刘进[3] 韩济生[3] 

机构地区：[1]张家口医学院二院麻醉镇痛科,河北075000 [2]中国医学科学院阜外医院麻醉科 [3]北京医科大学神经科学研究中心

出　　处：《中国疼痛医学杂志》1997年第2期99-103,共5页Chinese Journal of Pain Medicine

摘　　要：本文采用视觉模拟评分法，选择大剂量静脉芬太尼复合吸入麻醉、体外循环下心内直视手术后病人，自拔除气管导管开始至拔管后6天，对其疼痛、焦虑等进行调查。结果表明，疼痛以切口为主，咳嗽及活动时加重；疼痛强度在拔除气管导管后12～36小时显著高于平均水平（P＝0、0036，t检验）；疼痛程度与焦虑相关（r＝0．56咳动／0．57安静，P＜0、05）。聚类分析的结果提示，成人心血管外科手术后，约55％的病例疼痛较严重；疼痛严重者，在技管后4小时安静痛VAS评分均大于2。本调查为临床上准确选择病例、及时采取镇痛措施提供了依据。We investigated the pain and anxiety of patients after open heart surgery. All the operations were performed under fentanyl-combined inhalation anesthetics, with the support of artificial circulation. The seventy of pain and anxiety was assessed with visual analogue scale (VAS). The result showed that (1) pain was mainly located around the incision site;(2) pain during move or cough was severer than pain at rest; (3)pain score reached the peak 12-36 hours after the removal of intubation (student's t-test, P<0.01); and (4)pain scores correlated significantly with anxiety (the r value was 0. 56 for pain during move or cough, and 0. 57 for pain at rest, P<0.05). Cluster analysis indicated that 55 % of patients after cardiac surgery suffered from severe pain. Within 4 hours after the removal of intubation, all patients with severe pain had a pain score at rest over 2. Our results present a criterion for the selection of cases with past-operative pain as well as the method of post-op erative analgesia.

关 键 词：心脏外科手术 疼痛 手术后 

分 类 号：R654.2[医药卫生—外科学] R441.1[医药卫生—临床医学]