胸腔镜辅助开胸手术患者术后慢性疼痛及影响因素的研究.pdf

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1、词鳜宽中华护理杂志加l4年7是第49卷第期01l胸腔镜辅助开胸手术患者术后慢性疼痛及影响因素的研究王慧朱力都菁刘薇刘红菊李单青梁乃新刘华平【摘要】目的描述胸腔镜辅助开胸手术(videoassistedthoracicsurgery，VATS)惠者术后慢性疼痛发生率并探讨其影响因素。方法在2013年6～9月，便利选取北京市某三级甲等综合医院胸外科行VATS手术的l10例患者，术后第1~7天疼痛程度采用数字评分量表(NumericalRatingScale，NRS)进行评估，术后第7天或出院时疼痛对机体功能的影响采用疼痛简明记录表(BriefPainInventor

2、y，BPI)相应的维度进行测量；术后2周、1个月、2个月和3个月时通过电话随访评估患者的疼痛程度和疼痛对机体功能的影响。结果患者术后3个月时术后慢性疼痛发生率为53．7％，l5．8％患者报告了有临床意义的疼痛女性和术后第1—4天活动时疼痛程度的平均值是术后3个月时有临床意义的慢性疼痛的影响因素。结论VATS患者术后疼痛控制问题应引起广大临床护理工作者的重视，患者住院期间术后急性疼痛的积极控制可能有助于减少术后慢性疼痛的发生。【关键词】胸外科手术；胸腔镜；疼痛，手术后Theprevalenceandpredictorsofchronicpostsurgicalpa

3、ininpatientswithvideo·assistedthoracicsurgery／WANGHni。ZHULi。DUJing。L1UWei，LIUHong-ju，LIShan-qing。LIANGNai-xin。LIUHua·ping【Abstract】ObjectiveTodescribethepravelanceandpredictorsofchronicpostsurgicalpain(CPSP)inpatientsundergoingvideo—assistedthoracicsurgery(VATS)．MethodsFromJunetoSept

4、ember2013，atotalof110adultpatientsundergoingvideoassistedthoracicsurgery(VATS)wererecruitedfromathoracicdepartmentatatertiaryfirst—classhospitalinBeijing，China，usingconveniencesampling．Thepatients’painintensityatrest，whenmovingandwhencoughingwereassessedfromthefirsttoseventhpostopera

5、tiveday，usingtheNumericalRatingScale(NRS0-10)．Patientswereaskedtoscoretheinterferenceswithfunctionsofthepain，usingitemsfromtheBriefPainIn—ventory(BPI)，attheseventhdaypostoperativeordischargingday，aswellasduringfollow—upsbytelephoneat2weeks，1month，2monthsand3monthsaftersurgery：painint

6、ensitywasalsoratedduringeachfollow-up．ResultsTheprevalanceofCPSPinpatients3monthsaftersurgerywasabout53．7％．while15．8％ofpatientsreportedclin—icallyimportantpain．FemaleandaveragepainwhenmovingfromthefirsttothefourthpostoperativedaywerepredictorsforclinicallyimportantCPSPat3monthsafters

7、urgery．ConclusionPainmanagementinpatientswithVATSshouldbeaddressedbyclinicalnursingprofessionals．AggressivepostoperativepainmanagementmightbebenificialtopatientsbydecreasingprevalanceofCPSP．【Keywords】ThoracicSurgicalProcedures；Thoracoscopes；Pain，Postoperative胸外科手术是疼痛程度最重的外科手术方式程度评估中数

8、字评分量表(NRS)评分