早期食管癌患者行内镜下黏膜剥离术后不同角度体位对其疼痛的影响  

Impact of different posture angles on the pain of patients with early esophageal cancer after endoscopic submucosal dissection

作　　者：田恬 李娟 吴兆荣 王静[1,2] 王倩 李雯 Tian Tian;Li Juan;Wu Zhaorong;Wang Jing;Wang Qian;Li Wen(Department of Gastroenterology,Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine,Nanjing 210000,China;Department of Gastroenterology,Nanjing Drum Tower Hospital,Nanjing 210000,China)

机构地区：[1]南京中医药大学鼓楼临床医学院消化内科,南京210000 [2]南京鼓楼医院消化内科,南京210000

出　　处：《中国实用护理杂志》2024年第16期1201-1206,共6页Chinese Journal of Practical Nursing

基　　金：江苏省研究生科研与实践创新计划项目(SJCX23_0827);南京市卫生科技发展专项资金项目(GBX21294);南京鼓楼医院护理科研重点项目(2023-H444)。

摘　　要：目的探讨不同角度体位对行内镜下黏膜剥离术(ESD)的早期食管癌患者疼痛的改善效果和舒适度的影响,为患者ESD术后选择最佳体位提供依据。方法采用随机对照试验,选取2021年3月至2022年3月在南京鼓楼医院消化内科接受ESD的120例早期食管癌患者作为研究对象,按随机数字表法分为4组,每组30例,4组均为常规护理,A组术后取自由体位,B组术后取头高脚低30°卧位,C组术后取头高脚低45°卧位,D组术后取头高脚低60°卧位。观察对比4组患者术后回病房和术后8、16、24 h疼痛数字评定量表(NRS)评分及术后24 h Kolcaba舒适状况量表(GCQ)评分。结果A组男17例,女13例;B组男20例,女10例;C组男22例,女8例;D组男19例,女11例。所有患者年龄为30~85岁。4组患者术后疼痛NRS评分的时间主效应、分组主效应和交互效应均有统计学意义(F=618.13、12.14、6.75,均P<0.01)。4组患者术后回病房时的疼痛NRS评分比较差异无统计学意义(P>0.05)。D组术后8、16 h疼痛NRS评分分别为(1.93±0.64)、(0.60±0.47)分,低于A、B、C组(2.87±1.14)、(1.97±1.22)分,(2.17±0.83)、(0.97±0.61)分,(2.30±0.75)、(0.80±0.61)分,差异均有统计学意义(t值为0.79~4.72,均P<0.05);术后24 h B组疼痛NRS评分为(0.23±0.18)分,低于A、C、D组的(1.53±1.08)、(0.30±0.21)、(0.46±0.25)分,差异均有统计学意义(t=5.32、1.34、1.37,均P<0.05);A、B、C、D组患者术后24 h GCQ总分分别为(96.96±3.05)、(99.77±3.21)、(93.53±3.76)、(92.20±3.69)分,差异有统计学意义(F=29.59,P<0.05),且B组患者高于A、C、D组,差异均有统计学意义(t=3.15、7.01、8.52,均P<0.05)。结论针对性体位管理可有效减轻行ESD的早期食管癌患者术后疼痛,提高患者舒适度。Objective To explore the effect of different posture angles on the pain and comfort in patients with early esophageal cancer after endoscopic submucosal dissection(ESD),so as to provide a basis for patients to choose the best position after ESD.Methods This study was a randomized controlled trial.One hundred and twenty patients with early esophageal cancer who underwent ESD in the Department of Gastroenterology,Nanjing Drum Tower Hospital from March 2021 to March 2022 were selected as the study subjects,and they were randomly divided into 4 groups of 30 patients each according to the randomized numerical method.Group A was the conventional group,which was in the free position after the operation,and groups B,C,and D were the experimental groups,with group B in the head-high-feet-low 30°position,group C in the head-high-feet-low 45°position,and group D in the head-high-feet-low 60°position.The pain scores after returning to the room after the operation,at 8,16,24 h after the operation and comfort scores at 24 h after the operation of the patients in the four groups were evaluated by Numeric Rating Scale(NRS)and General Comfort Questionnaire(GCQ).Results There were 17 males and 13 females in group A;there were 20 males and 10 females in group B;there were 22 males and 8 females in group C;there were 19 males and 11 females in group D.All patients were aged 30-85 years old.The time main effect,grouping main effect,and interaction effect of postoperative pain NRS score among four groups of patients were all statistically significant(F=618.13,12.14,6.75,all P<0.01).There was no significant difference in the NRS scores of patients after returning to the room after the operation among the four groups(P>0.05).The NRS scores in group D at 8 and 16 h after the operation were(1.93±0.64),(0.60±0.47)points,lower than the(2.87±1.14),(1.97±1.22)points,(2.17±0.83),(1.97±1.61)points,(2.30±0.75),(0.80±0.61)points in groups A,B,and C,the differences were statistically significant(t values were 0.79-4.72,all P<0.05).The N

关 键 词：护理 早期食管癌 内镜下黏膜剥离术 体位管理 舒适度 

分 类 号：R735.1[医药卫生—肿瘤]