心脏外科正中开胸手术后疼痛护理管理  

Pain care management after cardiac surgery

作　　者：孙君辉[1] 秦彦荣[1] 谷静媛 许李力[1] 焦玉清[1] 孟旭[1] 

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管病研究所心脏外科,100029

出　　处：《心肺血管病杂志》2015年第12期921-924,共4页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:通过患者围术期及术后随访疼痛评分、用药情况,建立个体化有针对性的疼痛护理管理方案。方法:选取2014年5月至2015年5月,在北京安贞医院行正中开胸心外手术的601例患者,其中先天性心脏病(先心病)患者151例,占25.1%,风湿性心脏病患者382例,占63.6%,冠状动脉粥样硬化性心脏病61例,占10.1%,其它疾病患者7例。在术后出监护室时、出院时、出院一周拆线时、术后1个月门诊复查时、术后3个月门诊复查时,分别进行疼痛量表评分调查,并根据用药情况和疼痛原因,给出针对性疼痛护理方案。结果:患者在五个时间点评分为术后出监护室时3.57±1.3,出院时3.25±0.75,出院1周拆线时2.13±0.62,术后1个月门诊复查时1.55±0.91,术后3个月门诊复查时0.63±0.51,其均值随着随诊时间延长逐渐下降,但是在术后一个月时数值的离散度加大,为患者围术期疼痛原因未解除,转为慢性疼痛。结论:患者在传统正中开胸心外科手术后,疼痛评分为低强度的,在术后1个月左右有疼痛性质的分化,应针对个体情况进行疼痛护理管理。Objective： By perioperative and postoperative follow-up,this study will establish individualized pain care management program. Methods： From May 2014 to May 2015,601 patients were selected in this study who underwent cardiac surgery,in which 151 cases（ 25. 1%） were congenital heart disease,382 cases（ 63. 6%） were rheumatic heart disease,61 cases（ 10. 1%） were coronary heart disease,and 7 cases were other diseases. These patients were followed up at 5 time-points to fill a pain scores table（ PS） and describe the causes of their pain. the first was in the intensive care unit（ ICU） after surgery,the second was just discharged,the third was a week after discharged,the forth was one month after surgery and the fifth was three months after surgery. Results： The pain scores（ PS） were（ 3. 57 ± 1. 3） in the intensive care unit after surgery,were（ 3. 25 ± 0. 75） when discharged,were（ 2. 13 ± 0. 62） a week after discharged,were（ 1. 55 ± 0. 91）at one month after surgery and were（ 0. 63 ± 0. 51） three months after surgery. The mean values of the pain scores（ PS） gradually decreased as followed up. But after one month,the values of pain score（ PS） were more scatter. Conclusions： At first,these patients＇ pain score（ PS） was low intensity,but after a month,the property of pain is differentiation. So pain care management should be individually applied to patient.

关 键 词：心脏外科 疼痛评分 护理管理 

分 类 号：R54[医药卫生—心血管疾病]