疼痛管理联合阶段性健康教育在膝关节置换术患者中的应用
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摘要
目的:探讨疼痛管理联合阶段性健康教育在膝关节置换术患者中的应用方法与效果。方法:将84例膝关节置换术患者随机分为对照组与观察组各42例,对照组围术期行常规护理干预,观察组在对照组基础上实施疼痛管理联合阶段性健康教育。比较两组患者干预效果。结果:观察组术后24、48、72 h及出院时的疼痛评分均显著低于对照组(P<0.05);观察组24 h睡眠时间、首次下地时间、膝关节屈曲≥90°所需时间、主动直腿抬高时间及住院时间均短于对照组(P<0.05);观察组术后并发症发生率低于对照组(P<0.05);观察组术后1、7、14 d的膝关节活动度(ROM)水平显著高于对照组(P<0.05);术后3个月两组患者生活质量量表(SF-36)各维度评分均显著高于术后1 d(P<0.05),且除精力与情感职能维度外,观察组提高幅度高于对照组(P<0.05)。结论:疼痛管理联合阶段性健康教育有助于缓解膝关节置换术患者术后疼痛程度,促进患者术后恢复,提高生活质量。
Objective:To explore the application method and effect of pain management combined with staged health education in patients with knee joint replacement.Methods:A total of 84 cases of knee joint replacement patients were randomly divided into control group and observation group with 42 cases each.The control group received perioperative routine nursing intervention,and the observation group received pain management combined with staged health education on the basis of control group.The effect of intervention was compared between the two groups.Results:The pain scores of the observation group were significantly lower than those of the control group at 24,48,72 hours after operation and at discharge(P<0.05).In the observation group,the sleep time of 24 hours,the time of the first time to stand on the ground,knee flexion ≥ 90°,the time of active straight leg elevation and hospital stay were all shorter than those of the control group(P<0.05).The incidence of postoperative complications in the observation group was lower than that in the control group(P<0.05).The ROM level of the observation group was significantly higher than that of the control group at 1,7 and 14 days after operation(P<0.05).SF-36 scores in all dimensions 3 months after operation were significantly higher than that of 1 day after operation in both groups(P<0.05).Except for the dimensions of energy and emotional function,the improvement of the observation group was higher than that of the control group(P<0.05).Conclusion:The pain management combined with staged health education in patients with knee joint replacementis is helpful to relieve postoperative pain,promote postoperative recovery and improve the quality of life.
Objective:To explore the application method and effect of pain management combined with staged health education in patients with knee joint replacement.Methods:A total of 84 cases of knee joint replacement patients were randomly divided into control group and observation group with 42 cases each.The control group received perioperative routine nursing intervention,and the observation group received pain management combined with staged health education on the basis of control group.The effect of intervention was compared between the two groups.Results:The pain scores of the observation group were significantly lower than those of the control group at 24,48,72 hours after operation and at discharge(P<0.05).In the observation group,the sleep time of 24 hours,the time of the first time to stand on the ground,knee flexion ≥ 90°,the time of active straight leg elevation and hospital stay were all shorter than those of the control group(P<0.05).The incidence of postoperative complications in the observation group was lower than that in the control group(P<0.05).The ROM level of the observation group was significantly higher than that of the control group at 1,7 and 14 days after operation(P<0.05).SF-36 scores in all dimensions 3 months after operation were significantly higher than that of 1 day after operation in both groups(P<0.05).Except for the dimensions of energy and emotional function,the improvement of the observation group was higher than that of the control group(P<0.05).Conclusion:The pain management combined with staged health education in patients with knee joint replacementis is helpful to relieve postoperative pain,promote postoperative recovery and improve the quality of life.
引文
[1] 刘广秀.健康教育联合PDCA循环在预防髋、膝关节置换术后下肢深静脉血栓形成中的应用[J].齐鲁护理杂志,2016,22(8):24-26.
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[4] 宋海燕,李颖,李倩倩,等.图文式健康教育路径在膝关节置换中的应用效果[J].安徽医学,2016,37(7):904-906.
[5] 李春蕊,张雯,樊碧发.数字评分法(NRS)与口述评分法(VRS)在老年慢性疼痛患者中的比较[J].中国疼痛医学杂志,2016,22(9):683-686.
[6] 王振中,崔寅鹏,郭艾.SF-36量表对髋膝关节置换术后患者健康情状评估的应用[J].首都医科大学学报,2015,36(6):974-977.
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[8] 李志刚,李军,张会文,等.人工膝关节置换围术期规范化疼痛管理[J].中国煤炭工业医学杂志,2017,20(1):30-33.
[9] 秦瑕,何洁,易德坤,等.患者自主疼痛评估在全膝关节置换术围手术期疼痛管理中的应用效果[J].华西医学,2017,32(9):24-29.
[10] 贺葵,申利英,郭雪梅.疼痛管理对全膝关节置换患者术后疼痛及恢复的影响[J].实用临床医药杂志,2015,19(6):135-137.
[11] 雷玮,梁静娟.Teach-back用于全膝关节置换患者术后康复指导[J].护理学杂志,2016,31(16):75-77.
[12] 薛翌蔚,钱燕,董文君,等.多媒体健康教育在全膝关节置换术病人康复治疗中的应用[J].护理研究,2016,30(20):2489-2491.
[13] 田梅梅,杨柳柳,龚美芳,等.加速康复外科理念在人工全膝关节置换患者术后护理中的应用[J].中华现代护理杂志,2016,22(29):4233-4237.
[14] 贺静,魏威.护理干预对人工全膝关节置换术后疼痛及满意度的影响[J].实用临床医药杂志,2016,20(18):206-207.
[15] 李红贺,吴晶,孟杰,等.动机性访谈干预在全膝关节置换术患者早期康复中的应用效果[J].解放军护理杂志,2015,32(20):32-34.
[2] 葛敏,孟华,李蒙,等.丁丙诺啡透皮贴剂参与新型多模式镇痛方案在人工膝关节置换术后患者中的应用[J].齐鲁护理杂志,2017,23(2):80-82.
[3] 梁翠彬.规范化疼痛管理对全膝关节置换术后48 h内疼痛控制的影响[J].护士进修杂志,2016,31(3):239-241.
[4] 宋海燕,李颖,李倩倩,等.图文式健康教育路径在膝关节置换中的应用效果[J].安徽医学,2016,37(7):904-906.
[5] 李春蕊,张雯,樊碧发.数字评分法(NRS)与口述评分法(VRS)在老年慢性疼痛患者中的比较[J].中国疼痛医学杂志,2016,22(9):683-686.
[6] 王振中,崔寅鹏,郭艾.SF-36量表对髋膝关节置换术后患者健康情状评估的应用[J].首都医科大学学报,2015,36(6):974-977.
[7] 谭冠先.疼痛诊疗学[M].2版.北京:人民卫生出版社,2008:2.
[8] 李志刚,李军,张会文,等.人工膝关节置换围术期规范化疼痛管理[J].中国煤炭工业医学杂志,2017,20(1):30-33.
[9] 秦瑕,何洁,易德坤,等.患者自主疼痛评估在全膝关节置换术围手术期疼痛管理中的应用效果[J].华西医学,2017,32(9):24-29.
[10] 贺葵,申利英,郭雪梅.疼痛管理对全膝关节置换患者术后疼痛及恢复的影响[J].实用临床医药杂志,2015,19(6):135-137.
[11] 雷玮,梁静娟.Teach-back用于全膝关节置换患者术后康复指导[J].护理学杂志,2016,31(16):75-77.
[12] 薛翌蔚,钱燕,董文君,等.多媒体健康教育在全膝关节置换术病人康复治疗中的应用[J].护理研究,2016,30(20):2489-2491.
[13] 田梅梅,杨柳柳,龚美芳,等.加速康复外科理念在人工全膝关节置换患者术后护理中的应用[J].中华现代护理杂志,2016,22(29):4233-4237.
[14] 贺静,魏威.护理干预对人工全膝关节置换术后疼痛及满意度的影响[J].实用临床医药杂志,2016,20(18):206-207.
[15] 李红贺,吴晶,孟杰,等.动机性访谈干预在全膝关节置换术患者早期康复中的应用效果[J].解放军护理杂志,2015,32(20):32-34.