泌尿外科常见手术术后疼痛的现状调查及特点分析  

Investigation and analysis of current situation of postoperative pain in urology department

作　　者：郭良芳 廖艳[1] 杨清荣[1] 马莉[1] Guo Liangfang;Liao Yan;Yang Qingrong;Ma Li(Urology Department, Urology Research Institute, West China Hospital, Sichuan University, Chengdu 610041, China)

机构地区：[1]四川大学华西医院泌尿外科/泌尿外科研究所,成都610041

出　　处：《中华现代护理杂志》2018年第4期423-427,共5页Chinese Journal of Modern Nursing

摘　　要：目的 探讨泌尿科常见手术方式的术后疼痛情况，了解患者术后疼痛的特点，为更好地干预和治疗疼痛提供理论依据。方法 2016 年5 月，采用目的抽样法选择四川大学华西医院泌尿外科患有肾癌、前列腺癌、膀胱癌、肾上腺占位、尿道狭窄及肾囊肿6 类疾病并进行手术的179 例患者，由 6 名疼痛专科护士采用VAS 评分法对患者进行术后疼痛的回顾性评分。分析患者术后疼痛的时间、程度等特点。结果 肾脏手术患者术后最疼时间为术后4 h，疼痛程度为中度和重度；前列腺癌术后最疼时间集中在术后5 h，疼痛程度为中度；膀胱癌手术最疼时间集中在术后4～5 h，疼痛程度为重度；肾上腺术后最疼时间集中在术后4 h，疼痛程度是中度；尿道重建手术最疼时间在术后2～4 h，疼痛程度为中度；肾囊肿去顶减压手术最疼时间在术后2～3 h，疼痛程度为轻度。所调查的6类病种其术后最疼时间的疼痛程度与术后6、12、24、48 h疼痛程度比较，差异均有统计学意义（P＜ 0.05）。结论 泌尿外科常见病种患者其术后的疼痛程度为中度或以上；术后6～48 h 的VAS 评分逐渐降低；患者最疼时间约为术后5 h 内，多在麻醉复苏后表现出来。根据这些常见手术的疼痛特点建立更为精准的镇痛干预措施是泌尿外科围术期疼痛管理的关键。Objective To analyze the status of postoperative pain subjected to the patients undergone the common operation methods in Urology Department, in order to understand the characteristics of the postoperative pain in the patients and to provide a theoretical basis for better intervention and treatment of the pain. Methods In May 2016, a total of 179 patients in Urology Department of West China Hospital of Sichuan University of 6 diseases, including renal carcinoma, prostate cancer, bladder cancer, adrenal gland occupying, urethral stricture and renal cyst, were selected by purposive sampling method. The postoperative pain were retrospective assessed by six pain specialist nurses using the Visual Analogue Scale （VAS）, and the time, degree and other characteristics of pain were analyzed. Results The most painful time of the patients undergoing renal surgery was about 4 hours after operation, and the degree of pain was mainly moderate or severe ; the most painful time of prostate cancer was about 5 hours after operation, and the degree of pain was moderate; the most painful time of bladder cancer was 4 to 5 hours after surgery, and the degree of pain was severe ; the most painful time after adrenal surgery was 4 hours after surgery, and the pain was moderate; the most painful time of urethral reconstructive surgery was 2 to 4 hours after surgery, and the pain was moderate; the most painful time of renal cyst decompression surgery was 2 to 3 hours after surgery, and the degree of pain was mild. The degree of pain at the most painful times of the six investigated kinds of diseases were different from those at 6 h, 12 h, 24 h and 48 h after operation, and the differences were statistically significant （P 〈 0.05）. Conclusions The degree of postoperative pain in patients with common urological diseases was mostly moderate or above. The VAS score of the pain reduces gradually in 6 to 48 hours after operation, and the most painful time of all patients is within 5 hours after surgery, which appears mostly after anest

关 键 词：泌尿外科手术 疼痛 手术后 横断面研究 疼痛时间 疼痛程度 

分 类 号：R473.6[医药卫生—护理学]