個(gè)體化疼痛護(hù)理對(duì)手術(shù)后切口疼痛及止痛藥物用量的影響研究

吳勇飛

【摘要】 目的：探究針對(duì)性疼痛護(hù)理對(duì)甲狀腺手術(shù)后切口疼痛及止痛藥物用量的影響。方法：選取筆者所在醫(yī)院2018年1月-2019年3月收治的甲狀腺手術(shù)后切口疼痛患者102例，采用雙盲法分為甲組和乙組，各51例。甲組采用針對(duì)性疼痛護(hù)理干預(yù)，乙組采用常規(guī)護(hù)理干預(yù)。護(hù)理1個(gè)月開展隨訪，觀察疼痛評(píng)分、舒適感評(píng)分、精神健康評(píng)分、生活質(zhì)量評(píng)分、止痛藥物用量及不良反應(yīng)發(fā)生情況。結(jié)果：甲組疼痛及精神健康評(píng)分均低于乙組，舒適感及生活質(zhì)量評(píng)分均高于乙組，差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）。甲組止痛藥物用量為（64.44±10.05）mg，少于乙組的（98.78±15.69）mg，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。甲組不良反應(yīng)發(fā)生率為1.96%，低于乙組的15.69%，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論：針對(duì)性疼痛護(hù)理在甲狀腺手術(shù)后切口疼痛患者中具有顯著效果，可改善其身心狀態(tài)及疼痛感，并減少止痛藥物用量及不良反應(yīng)，值得應(yīng)用于臨床推廣。

【關(guān)鍵詞】 針對(duì)性疼痛護(hù)理 甲狀腺手術(shù) 切口疼痛 舒適感 不良反應(yīng)

[Abstract] Objective： To explore the effect of targeted pain nursing on incision pain and analgesic drug dosage after thyroid surgery. Method： A total of 102 patients with incision pain after thyroid surgery admitted to our hospital from January 2018 to March 2019 were selected， and were divided into group A and group B by double-blind method， with 51 patients in each group. Targeted pain nursing intervention was used in group A and routine nursing intervention was used in group B. The patients were followed up for 1 month， the pain score， comfort score， mental health score， quality of life score， analgesic drug dosage and adverse reactions were observed. Result： The scores of pain and mental health in group A were lower than those in group B， and the scores of comfort and quality of life in group A were significantly higher than those in group B， the differences were statistically significant （P<0.05）. The analgesic dosage of group A was （64.44±10.05） mg， lower than （98.78±15.69） mg of group B， the difference was statistically significant （P<0.05）. The incidence of adverse reactions in group A was 1.96%， which was lower than 15.69% in group B， the difference was statistically significant （P<0.05）. Conclusion： Targeted pain nursing in patients with incision pain after thyroid surgery has a significant effect， can improve their physical and mental state and pain， and reduce the amount of analgesic drugs and adverse reactions， is worth applying in clinical promotion.

甲狀腺是有脊髓動(dòng)物體內(nèi)重要腺體之一，直接參與內(nèi)分泌系統(tǒng)，主要負(fù)責(zé)調(diào)節(jié)人體鈣質(zhì)的平衡狀態(tài)[1]。甲狀腺手術(shù)是臨床針對(duì)甲狀腺疾病患者實(shí)施的主要治療措施，通過針對(duì)病灶實(shí)施切除或清掃來達(dá)到治療效果。而治療中，由于手術(shù)屬于侵入性操作，外加病灶部位較為特殊，患者術(shù)后切口極易產(chǎn)生疼痛感，并對(duì)其身心狀態(tài)造成影響[2-3]。因此，在甲狀腺手術(shù)后應(yīng)及時(shí)輔以護(hù)理干預(yù)，有效控制其疼痛感及用藥，減少不良反應(yīng)發(fā)生。筆者所在醫(yī)院圍繞甲狀腺手術(shù)后切口疼痛護(hù)理開展研究，整理報(bào)道如下。

1 資料與方法

1.1 一般資料

選取筆者所在醫(yī)院2018年1月-2019年3月收治的甲狀腺手術(shù)后切口疼痛患者102例。納入標(biāo)準(zhǔn)：（1）患者均接受甲狀腺手術(shù)治療;（2）經(jīng)臨床病理學(xué)及影像學(xué)診斷確診為甲狀腺疾病[4]。排除標(biāo)準(zhǔn)：（1）合并嚴(yán)重手術(shù)禁忌證;（2）抗拒或抵觸研究;（3）對(duì)研究采用止痛藥物成分過敏;（4）合并其他臟器腫瘤;（5）參與其他研究。采用雙盲法分為甲組和乙組，各51例。甲組男26例，女25例，年齡21～70歲，平均（45.4±1.4）歲;乙組男25例，女26例，年齡22～70歲，平均（45.5±1.3）歲。兩組一般資料對(duì)比差異無統(tǒng)計(jì)學(xué)意義（P>0.05）。患者均對(duì)本研究知情同意。