程序化疼痛管理配合心理疏导对肺大泡切除术患者术后疼痛、心理状态及生活质量的影响
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摘要
目的:探讨程序化疼痛管理配合心理疏导对肺大泡切除术患者术后疼痛、心理状态及生活质量的影响。方法:以2016年3月-2017年3月本院收治的136例肺大泡切除术患者为研究对象,按照入院顺序奇偶数编号分为对照组和观察组各68例,对照组实施心理疏导干预,观察组实施程序化疼痛管理配合心理疏导干预,观察两组术后疼痛[视觉模拟疼痛评分(VAS)]、心理状态[焦虑自评量表(SAS)、抑郁自评量表(SDS)]、生活质量[生活质量评价量表(SF-36)]及并发症发生情况。结果:术后24、48、72h观察组VAS评分明显低于对照组,有统计学意义(F=26.486,P<0.01);干预后观察组SAS、SDS评分均较对照组明显低(t=-18.861,-25.087;P<0.01);干预后观察组生理功能评分、社会功能评分和健康状况评分均较对照组明显高(t=9.268,10.292,8.422;P<0.01);观察组并发症总发生率明显低于对照组(χ~2=4.955,P<0.05)。结论:程序化疼痛管理配合心理疏导应用于肺大泡切除术患者中,在减轻患者术后疼痛、改善心理状态、生活质量及降低并发症发生率方面有明确效果。
Objective:To investigate the effect of procedural pain management combined with psychological counseling on postoperative pain,psychological state and quality of life of patients undergoing resection of pulmonary bullae.Methods:A total of 136 patients undergoing resection of pulmonary bullae in the hospital from March 2016 to March 2017 were studied.They were divided into the control group and the observation group according to odd and even number of admission,68 cases in each group.The control group was given psychological counseling intervention,while the observing group was given procedural pain management combined with psychological counseling intervention.The postoperative pain[pain visual analogue scale(VAS)],psychological state[Self-rating Anxiety Scale(SAS),Self-rating Depression Scale(SDS)],quality of life[quality of life assessment scale(SF-36)]and the incidence of complications in both groups were observed.Results:The VAS scores of the observation group were significantly lower than those of the control group at 24,48 and 72 hours after operation(F=26.486,P<0.01).The SAS and SDS scores of the observation group were significantly lower than those of the control group after the intervention(t=-18.861,-25.087;P<0.01);After the intervention,the scores of physiological function,social function and health status of the observation group were significantly higher than those of the control group(t=9.268,10.292,8.422;P<0.01).The total incidence of complications in the observation group was significantly lower than that in the control group(χ~2=4.955,P<0.05).Conclusion:The application of procedural pain management combined with psychological counseling in patients undergoing resection of pulmonary bullae has clear effects in reducing postoperative pain,improving psychological state and quality of life,and reducing the incidence of complications.
Objective:To investigate the effect of procedural pain management combined with psychological counseling on postoperative pain,psychological state and quality of life of patients undergoing resection of pulmonary bullae.Methods:A total of 136 patients undergoing resection of pulmonary bullae in the hospital from March 2016 to March 2017 were studied.They were divided into the control group and the observation group according to odd and even number of admission,68 cases in each group.The control group was given psychological counseling intervention,while the observing group was given procedural pain management combined with psychological counseling intervention.The postoperative pain[pain visual analogue scale(VAS)],psychological state[Self-rating Anxiety Scale(SAS),Self-rating Depression Scale(SDS)],quality of life[quality of life assessment scale(SF-36)]and the incidence of complications in both groups were observed.Results:The VAS scores of the observation group were significantly lower than those of the control group at 24,48 and 72 hours after operation(F=26.486,P<0.01).The SAS and SDS scores of the observation group were significantly lower than those of the control group after the intervention(t=-18.861,-25.087;P<0.01);After the intervention,the scores of physiological function,social function and health status of the observation group were significantly higher than those of the control group(t=9.268,10.292,8.422;P<0.01).The total incidence of complications in the observation group was significantly lower than that in the control group(χ~2=4.955,P<0.05).Conclusion:The application of procedural pain management combined with psychological counseling in patients undergoing resection of pulmonary bullae has clear effects in reducing postoperative pain,improving psychological state and quality of life,and reducing the incidence of complications.
引文
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[11]张淼,潘雪峰,张辉.分期双侧单孔胸腔镜肺减容术的临床分析[J].中国胸心血管外科临床杂志,2016,20(1):25-28
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[13]李云霞,龚雅萍,邱瑾.老年患者全膝关节置换术围手术期程序化疼痛护理规程的建立与应用[J].中国实用护理杂志,2014,30(12):19-23
[14]蔡玮,史嘉丽,曾子凌.电视胸腔镜下90例肺大泡切除术患者的围术期护理干预[J].中国现代药物应用,2016,10(8):234-235
[15]秦淑玉,夏瑾.程序化管理在手术室无瘤技术操作中的应用研究[J].重庆医学,2017,46(16):2262-2264
[16]郑洁,卢容.疼痛管理在胸外科患者术后的应用及疗效观察[J].护士进修杂志,2017,32(7):641-643
[2]陈章,廖小清,郑义文.单孔法在胸腔镜肺大泡切除术的临床应用研究[J].实用医院临床杂志,2017,14(3):79-80
[3]黄丽仪,徐继海,李华忠,等.胸腔镜下肺大泡切除术的手术配合[J].广东医学,2014,35(10):1632-1633
[4]吕世进,周海燕,沈伟钢,等.肺结核患者胸部手术后不同镇痛方式对术后感染的影响[J].中华医院感染学杂志,2017,27(10):2271-2274
[5]秦淑玉,夏瑾.程序化管理在手术室无瘤技术操作中的应用研究[J].重庆医学,2017,46(16):2262-2264
[6]Salzmann S,Euteneuer F,Jac L,et al.Effects of preoperative psychological interventions on catecholamine and cortisol levels after surgery in coronary artery bypass graft patients:The randomized controlled PSY-HEART trial[J].Psychosomatic Medicine,2017,79(7):806-814
[7]郑娟如,吴丹燕,黄旭华,等.心理干预对泌尿外科后腹腔镜手术患者焦虑和抑郁的影响[J].广东医学,2016,37(21):3318-3319
[8]任春霞.心理护理在胸腔镜下切除肺大泡围术期中的应用[J].中华现代护理杂志,2014,49(27):3473-3475
[9]Merz W A,Ballmer U.Demographic factors influencing psychiatric rating scales(Zung SDS and SAS)[J].Pharmacopsychiatry,1984,17(02):50-56
[10]李春波,何燕玲.健康状况调查问卷SF-36的介绍[J].国外医学:精神病学分册,2002,29(2):116-119
[11]张淼,潘雪峰,张辉.分期双侧单孔胸腔镜肺减容术的临床分析[J].中国胸心血管外科临床杂志,2016,20(1):25-28
[12]章红霞.术前信息支持联合心理护理干预对普外科手术病人围手术期恐惧性焦虑的干预作用[J].中国健康心理学杂志,2018,26(1):55-58
[13]李云霞,龚雅萍,邱瑾.老年患者全膝关节置换术围手术期程序化疼痛护理规程的建立与应用[J].中国实用护理杂志,2014,30(12):19-23
[14]蔡玮,史嘉丽,曾子凌.电视胸腔镜下90例肺大泡切除术患者的围术期护理干预[J].中国现代药物应用,2016,10(8):234-235
[15]秦淑玉,夏瑾.程序化管理在手术室无瘤技术操作中的应用研究[J].重庆医学,2017,46(16):2262-2264
[16]郑洁,卢容.疼痛管理在胸外科患者术后的应用及疗效观察[J].护士进修杂志,2017,32(7):641-643