手术室舒适护理对肋间神经阻滞联合自控镇痛患者术后镇痛效果及满意度的影响
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摘要
目的探讨手术室舒适护理对肋间神经阻滞联合自控镇痛患者术后镇痛效果及满意度的影响。方法选择2013年1月—2017年2月在湖北医药学院附属东风医院收治的乳腺癌患者140例作为研究对象,所有患者按随机数字分为观察组与对照组各70例,所有患者都给予肋间神经阻滞联合自控镇痛,对照组在手术室给予常规护理,观察组在对照组护理的基础上给予手术室舒适护理。记录2组的麻醉效果、疼痛情况、护理满意度与生活质量情况。结果所有患者都顺利完成麻醉阻滞与手术,无严重并发症发生,2组的麻醉起效时间、完善时间对比差异均无统计学意义(均P>0.05)。观察组的切皮即刻与术毕疼痛评分分别为(1.55±0.45)分和(0.56±0.55)分,明显低于对照组的(2.76±1.22)分和(1.43±0.82)分(均P<0.05)。观察组与对照组对护理的满意度分别为100.0%和88.6%,观察组优于对照组(P<0.05)。随访6个月,观察组的心理健康、精神健康、躯体疼痛、社会支持评分均明显高于对照组(均P<0.05)。结论肋间神经阻滞联合自控镇痛在乳腺癌患者中的应用具有很好的麻醉效果,手术室舒适护理的应用能提高镇痛效果,改善护患关系,促进患者生存质量的提高。
Objective To investigate the effects of comfort care in operation room on postoperative analgesia and satisfaction of patients with intercostal nerve block combined with controlled analgesia.Methods From January,2013 to February,2017,140 cases of breast cancer patients in our hospital were selected as the subjects,and all the patients were randomly divided the observation group and control group with 70 cases in each group.All patients were given intercostal nerve block combined with controlled analgesia,the control group received routine nursing in operation room,and the observation group was given comfortable nursing in operation room nursing based on the control group.We recorded anesthesia,pain,quality of life and satisfaction of nursing care of the two groups.Results All the patients successfully completed anesthesia block without serious complications.The analgesia onset time,perfect time compared between the two groups were not significantly different( P > 0.05).The immediate and postoperative pain scores in the observation group were( 1.55 ± 0.45) points and( 0.56 ± 0.55) points which were significantly lower than( 2.76 ± 1.22) points and( 1.43 ± 0.82) points of the control group( P < 0.05).The postoperative satisfaction degree in the observation group and the control group were 100.0% and 88.6% respectively,and the observation group was better than that of the control group( P < 0.05).After 6 months follow-up,the scores of psychological health,mental health,physical pain and social support in the observation group were significantly higher than those of the control group( P < 0.05).Conclusion There is a good anesthetic effect of intercostal nerve block combined with controlled analgesia in patients with breast cancer.Application of comfort care in the operation room can enhance the analgesic effect,improve the nurse patient relationship,and promote the survival quality.
Objective To investigate the effects of comfort care in operation room on postoperative analgesia and satisfaction of patients with intercostal nerve block combined with controlled analgesia.Methods From January,2013 to February,2017,140 cases of breast cancer patients in our hospital were selected as the subjects,and all the patients were randomly divided the observation group and control group with 70 cases in each group.All patients were given intercostal nerve block combined with controlled analgesia,the control group received routine nursing in operation room,and the observation group was given comfortable nursing in operation room nursing based on the control group.We recorded anesthesia,pain,quality of life and satisfaction of nursing care of the two groups.Results All the patients successfully completed anesthesia block without serious complications.The analgesia onset time,perfect time compared between the two groups were not significantly different( P > 0.05).The immediate and postoperative pain scores in the observation group were( 1.55 ± 0.45) points and( 0.56 ± 0.55) points which were significantly lower than( 2.76 ± 1.22) points and( 1.43 ± 0.82) points of the control group( P < 0.05).The postoperative satisfaction degree in the observation group and the control group were 100.0% and 88.6% respectively,and the observation group was better than that of the control group( P < 0.05).After 6 months follow-up,the scores of psychological health,mental health,physical pain and social support in the observation group were significantly higher than those of the control group( P < 0.05).Conclusion There is a good anesthetic effect of intercostal nerve block combined with controlled analgesia in patients with breast cancer.Application of comfort care in the operation room can enhance the analgesic effect,improve the nurse patient relationship,and promote the survival quality.
引文
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[18]王芸,缪长虹,许平波.全麻复合肋间神经阻滞对乳腺癌改良根治术后镇痛效果的影响[J].中国癌症杂志,2015,22(7):544-548.
[19]Simon F,Tapia P,Armisen R,et al.Human Peritoneal Mesothelial Cell Death Induced by High-Glucose Hypertonic Solution Involves Ca(2+)and Na(+)Ions and Oxidative Stress with the Participation of PKC/NOX2 and PI3K/Akt Pathways[J].Front Physiol,2017,13(8):379.
[20]Jafri SIM,Ali N,Farhat S,et al.The tell-tale heart:A case of recurrent vulvar carcinoma with cardiac metastasis and review of literature[J].Gynecol Oncol Rep,2017,3(21):20-23.
[2]Oi H,Hashimoto T,Nozawa T,et al.Neural correlates of ambient thermal sensation:An f MRI study[J].Sci Rep,2017,7(1):11279.
[3]Hu YQ,Wu YF,Hou LL.The Effectiveness of Electrical Acupuncture Stimulation in Reducing Levels of Self-reported Anxiety of Lung Cancer Patients during Palliative Care:A Pilot Study[J].Iran J Public Health,2017,46(8):1054-1061.
[4]黄接云,李敏,江鹤群,等.超声引导下肋间臂神经阻滞治疗乳房切除术后疼痛综合征的临床效果[J].临床麻醉学杂志,2017,33(3):257-260.
[5]Crosby RA,Hagensee ME,Fisher R,et al.Self-collected vaginal swabs for HPV screening:An exploratory study of rural Black Mississippi women[J].Prev Med Rep,2016,23(7):227-231.
[6]Dai K,Yu Q,Zhang Z,et al.Aromatic hydrocarbons in a controlled ecological life support system during a 4-person-180-day integrated experiment[J].Sci Total Environ,2017,8(19):610-611.
[7]杨海扣,周静,拾翠翠,等.右美托咪定复合罗哌卡因在乳腺癌术后镇痛中的应用[J].广东医学,2017,38(3):466-467,471.
[8]Bonnet A,Moreau P.Safety of ixazomib for the treatment of multiple myeloma[J].Expert Opin Drug Saf,2017,16(8):973-980.
[9]Swavey S,Morford K,Tsao M,et al.Heteroleptic monometallic and trimetallic ruthenium(Ⅱ)complexes incorporating aπ-extended dipyrrin ligand:Light-activated reactions with the A549 lung cancer cell line[J].J Inorg Biochem,2017,10(175):101-109.
[10]曹伟,周丹丹,龚辉,等.肋间神经阻滞复合全身麻醉用于乳腺癌根治手术的临床效果[J].现代肿瘤医学,2016,24(18):2971-2975.
[11]Pang EPP,Knight K,Baird M,et al.A comparison of interfraction setup error,patient comfort,and therapist acceptance for 2 different prostate radiation therapy immobilization devices[J].Adv Radiat Oncol,2017,2(2):125-131.
[12]Braithwaite CM,Ringdahl D.Nurse-Administered Hand Massage:Integration Into an Infusion Suite’s Standard of Care[J].Clin J Oncol Nurs,2017,21(4):E87-E92.
[13]Neagu TP,Sinescu RD,Enache V,et al.Metastatic high-grade myxofibrosarcoma:review of a clinical case[J].Rom J Morphol Embryol,2017,58(2):603-609.
[14]尤荻,赵国庆,郭文来,等.胸肌神经阻滞在乳腺癌改良根治术麻醉中的应用[J].中国实验诊断学,2016,20(3):473-474.
[15]Kulkarni AR,Pusic AL,Hamill JB,et al.Factors Associated with Acute Postoperative Pain Following Breast Reconstruction[J].JPRAS Open,2017,4(11):1-13.
[16]Coelho A,Parola V,Cardoso D,et al.Use of non-pharmacological interventions for comforting patients in palliative care:a scoping review[J].JBI Database System Rev Implement Rep,2017,15(7):1867-1904.
[17]Renfrow JJ,Strowd RE,Laxton AW,et al.Surgical Considerations in the Optimal Management of Patients with Malignant Brain Tumors[J].Curr Treat Options Oncol,2017,18(8):46.
[18]王芸,缪长虹,许平波.全麻复合肋间神经阻滞对乳腺癌改良根治术后镇痛效果的影响[J].中国癌症杂志,2015,22(7):544-548.
[19]Simon F,Tapia P,Armisen R,et al.Human Peritoneal Mesothelial Cell Death Induced by High-Glucose Hypertonic Solution Involves Ca(2+)and Na(+)Ions and Oxidative Stress with the Participation of PKC/NOX2 and PI3K/Akt Pathways[J].Front Physiol,2017,13(8):379.
[20]Jafri SIM,Ali N,Farhat S,et al.The tell-tale heart:A case of recurrent vulvar carcinoma with cardiac metastasis and review of literature[J].Gynecol Oncol Rep,2017,3(21):20-23.