鼻内镜术后留置硅胶扩张引流管患者疼痛控制现状及影响因素分析  

Analysis of pain control status and influencing factors in patients with silicone drainage tube after endoscopic sinus surgery

作　　者：李秀雅[1] 杨虹[1] 韩梅[1] 肖克珍[1] Li Xiuya;Yang Hong;Han Mei;Xiao Kezhen(ENT ＆ TIN Surgery Department, Belting Tongren Hospital,, Capital Medical University,. Beifing 100730, China)

机构地区：[1]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科,100730

出　　处：《中华现代护理杂志》2017年第31期3984-3987,共4页Chinese Journal of Modern Nursing

基　　金：首都医科大学附属北京同仁医院科研基金项目（20,15.YJJ.HLL-007）

摘　　要：目的 了解鼻内镜术后留置硅胶扩张引流管患者的疼痛程度、疼痛控制状况及影响因素,为患者的疼痛管理及舒适护理提供依据.方法 选取2016年3-8月鼻内镜手术患者102例,患者术后48h内留置硅胶扩张引流管.分别于术后24、48h应用简明疼痛量表（BPI）对患者的疼痛状况及其影响因素进行调查评估.结果 患者术后24~48h的疼痛最重程度、最轻程度、平均程度、现有程度及总体疼痛程度均较术后24h内明显减轻,差异均有统计学意义（t值分别为3.446、4.790、5.413、4.758、5.374;P〈0.05）;术后24~48h疼痛对日常生活、情绪、正常工作、睡眠的影响及总体影响均较术后24h内明显降低,差异均有统计学意义（t值分别为2.729、2.912、3.260、2.080、2.702;P〈0.05）;术后24~48h留置镇痛泵患者的总体疼痛评分为（2.15±1.69）分,未留置镇痛泵患者为（3.26±1.94）分,差异有统计学意义（t=2.871,P=0.005）.结论 对鼻内镜术后留置硅胶扩张引流管患者的疼痛护理不可忽视,特别是在术后24h内应加强对疼痛评估和管理,注重疼痛对患者的影响;对患者的疼痛控制不应采用单一的疼痛控制方式,应着重探索多种疼痛控制方式相结合的方式.Objective To investigate the degree of pain, pain control and influencing factors of patients with silicone drainage tube after endoscopic sinus surgery, so as to provide the basis for the management of pain and comfort nursing. Methods From March to August in 2016, 102 patients undergone endoscopic sinus surgery were selected as the research objects. They were treated with silicone drainage tube within 48 h after operation. The patient＇s pain status and its influencing factors were assessed by the Brief Pain Scale （BPI） at 24 h and 48 h after operation. Results In 24-48 h after surgery, the most degree of pain, the lightest degree of pain, the average degree of pain, the exist degree and the overall degree of pain were significantly reduced than those in 24 h after surgery,and the differences were statistically significant （t=3.446, 4.790, 5.413, 4.758, 5.374;P〈0.05）; In 24-48 h after the surgery, the pain impact on daily life, mood, work, sleep and overall effects were significantly reduced than those in 24 h after the surgery, and the differences were statistically significant （t=2.729, 2.912, 3.260, 2.080, 2.702; P 〈0.05）; 24-48 h after operation, the overall pain state of patients with patient-controlled analgesia （PCA） （2.15±1.69） was significantly lower than that patients who did not receive the PCA （3.26±1.94）, and the difference was statistically significant （t=2.871, P=0.005）. Conclusions The pain nursing of the patients with silicone tube should not be neglected, especially in 24 h after surgery nurses should strengthen the assessment and management of pain, and pay attention to the impact of pain; For pain control, we should not use single control mode, but should focus on exploring various ways to control pain.

关 键 词：疼痛 功能性鼻内镜手术 硅胶管 

分 类 号：R473.76[医药卫生—护理学]