个体化疼痛护理对手术后切口疼痛及止痛药物用量的影响研究

吴勇飞

【摘要】 目的：探究针对性疼痛护理对甲状腺手术后切口疼痛及止痛药物用量的影响。方法：选取笔者所在医院2018年1月-2019年3月收治的甲状腺手术后切口疼痛患者102例，采用双盲法分为甲组和乙组，各51例。甲组采用针对性疼痛护理干预，乙组采用常规护理干预。护理1个月开展随访，观察疼痛评分、舒适感评分、精神健康评分、生活质量评分、止痛药物用量及不良反应发生情况。结果：甲组疼痛及精神健康评分均低于乙组，舒适感及生活质量评分均高于乙组，差异均有统计学意义（P<0.05）。甲组止痛药物用量为（64.44±10.05）mg，少于乙组的（98.78±15.69）mg，差异有统计学意义（P<0.05）。甲组不良反应发生率为1.96%，低于乙组的15.69%，差异有统计学意义（P<0.05）。结论：针对性疼痛护理在甲状腺手术后切口疼痛患者中具有显著效果，可改善其身心状态及疼痛感，并减少止痛药物用量及不良反应，值得应用于临床推广。

【关键词】 针对性疼痛护理 甲状腺手术 切口疼痛 舒适感 不良反应

[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.

甲状腺是有脊髓动物体内重要腺体之一，直接参与内分泌系统，主要负责调节人体钙质的平衡状态[1]。甲状腺手术是临床针对甲状腺疾病患者实施的主要治疗措施，通过针对病灶实施切除或清扫来达到治疗效果。而治疗中，由于手术属于侵入性操作，外加病灶部位较为特殊，患者术后切口极易产生疼痛感，并对其身心状态造成影响[2-3]。因此，在甲状腺手术后应及时辅以护理干预，有效控制其疼痛感及用药，减少不良反应发生。笔者所在医院围绕甲状腺手术后切口疼痛护理开展研究，整理报道如下。

1 资料與方法

1.1 一般资料

选取笔者所在医院2018年1月-2019年3月收治的甲状腺手术后切口疼痛患者102例。纳入标准：（1）患者均接受甲状腺手术治疗;（2）经临床病理学及影像学诊断确诊为甲状腺疾病[4]。排除标准：（1）合并严重手术禁忌证;（2）抗拒或抵触研究;（3）对研究采用止痛药物成分过敏;（4）合并其他脏器肿瘤;（5）参与其他研究。采用双盲法分为甲组和乙组，各51例。甲组男26例，女25例，年龄21～70岁，平均（45.4±1.4）岁;乙组男25例，女26例，年龄22～70岁，平均（45.5±1.3）岁。两组一般资料对比差异无统计学意义（P>0.05）。患者均对本研究知情同意。