摘要
目的基于微信平台对我院行肺叶切除术的患者院外疼痛管理现状进行调查,以期为更好管理术后疼痛提供依据。方法选择2017年12月至2018年5月在我院胸外科出院的肺部手术后患者共449例,其中男156例、女293例,年龄22~83(55.54±11.17)岁。分别于出院后24~48 h和引流口拆线后24 h内采用简明疼痛评估量表对患者进行疼痛评估。结果出院后24~48 h内98.22%的患者存在疼痛,疼痛部位以引流口居多(45.21%),总体疼痛评分为2.75(2.00,3.25)分,此期82.85%的患者采用物理方式缓解疼痛。引流口拆线后24 h伤口疼痛者占79.29%,疼痛部位仍以引流口为主(47.88%),总体疼痛评分为1.75(1.25,2.25)分,此期73.94%的患者采用物理方式缓解疼痛。疼痛对患者总体影响程度得分为2.29(1.86,2.86)分和1.86(1.29,2.43)分,其中对睡眠和情绪的影响最大,得分分别为4.00(3.00,5.00)分、3.00(2.00,4.00)分和2.00(1.00,4.00)分、3.00(2.00,4.00)分。结论加速康复外科理念下,肺部疾病手术患者出院后总体疼痛水平为轻度疼痛,但患者对药物镇痛方法的应用率较低;疼痛对患者的总体影响程度较低,但对睡眠和情绪的影响较大,医务人员需加强对患者的疼痛教育,提高其院外疼痛自我管理能力。
Objective To investigate the current status of outpatient pain m anagem ent in patients with pulmonary disease after surgery by WeChat and to provide a basis for postoperative pain management.Methods A total of 449 patients who underw ent thoracic surgery in our hospital from December 2017 to May 2018 were enrolled,including 156 males and 293 females with an average age of 22-83(55.54±11.17)years.Brief Pain Inventory was adopted for pain assessment in 24-48 hours after discharge and 24 hours after removal of from the wound.Results Totally 98.22%of the patients reported that they suffered from pain in 24-48 h after discharge,most pain position was still at drainage port(45.21%),the overall pain score was 2.75(2.00,3.25)points,and 82.85%of patients adopted physical methods to relieve pain.After removal of stitches at the drainage port,79.29%of the patients suffered from pain,the pain site was mainly at the drainage port(47.88%),and the overall pain score was 1.75(1.25,2.25)points,and 73.94%of patients adopted physical methods to relieve pain.The score of the overall influence degree of pain on patients was 2.29(1.86,2.86)points and 1.86(1.29,2.43)points,while pain had the greatest influence on sleep and mood.The scores were 4.00(3.00,5.00)points,3.00(2.00,4.00)points and 2.00(1.00,4.00)points,3.00(2.00,4.00)points,respectively.Conclusion Under the concept of enhanced recovery after surgery,the overall pain level of patients with pulmonary disease after discharge is mild pain,but the application rate of drug analgesia in patients is low.The overall effect of pain on postoperative patients with lung cancer is low,but it has a great impact on sleep and mood.Medical staff should strengthen the pain education for patients in order to improve their pain self-management ability.
作者
杨梅
郑娥
林琳
周洪霞
马丹
张琴
YANG Mei;ZHENG E;LIN Lin;ZHOU Hongxia;MA Dan;ZHANG Qin(Department of Thoracic Surgery,West China Hospital,Sichuan University,Chengdu,610041,P.R.China;West China Med Co.LTD,Chengdu,610041,P.R.China)
出处
《中国胸心血管外科临床杂志》
CAS
CSCD
2019年第11期1098-1102,共5页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
基金
四川省科技厅基金（2017SZ0168）
关键词
肺部疾病
加速康复外科
疼痛
生活质量
Pulmonary disease
enhanced recovery after surgery
pain
quality of life
