脊柱结核患者术后行疼痛护理干预的效果观察

doi:10.3969/j.issn.1000-6621.2019.10.009

摘要/Abstract

摘要：

目的探讨脊柱结核患者术后行疼痛护理干预的临床效果。方法采用随机抽签法选取2016年1月至2017年6月于解放军总医院第八医学中心脊柱微创科就诊的40例脊柱结核患者作为对照组;选取2017年7月至2019年1月于解放军总医院第八医学中心脊柱微创科就诊的40例脊柱结核患者作为观察组。对照组患者于手术后实施常规护理,观察组患者于术后在常规护理基础上实施疼痛护理干预,比较两组患者术后3d、术后1周疼痛程度和舒适度,伤口愈合时间,术后住院时间,术后并发症发生情况。结果观察组术后3d、术后1周视觉模拟评分法(VAS)疼痛评分分别为(4.22±0.81)分、(2.22±0.81)分,均明显低于对照组[分别为(4.98±1.12)分、(2.98±1.12)分],差异均有统计学意义(t值均为3.48,P值均为0.000)。观察组术后3d、术后1周舒适度的VAS评分分别为(4.48±0.41)分、(2.20±0.80)分,均明显低于对照组[分别为(4.92±0.98)分、(2.96±1.12)分],差异均有统计学意义(t值分别为2.62、3.49,P值分别为0.005、0.000)。观察组术后伤口愈合时间、术后住院时间分别为(13.46±1.38)d、(13.49±1.87)d,均明显短于对照组[分别为(14.76±1.92)d、(14.86±2.54)d],差异均有统计学意义(t值分别为3.48、2.75,P值分别为0.000、0.003)。观察组术后并发症发生率为5.0%(2/40),明显低于对照组的25.0%(10/40),差异有统计学意义(χ ²=6.28,P=0.012)。结论脊柱结核患者术后行疼痛护理干预可减轻患者疼痛,提升生理舒适感,减少并发症,并促使其早期伤愈出院。

关键词: 结核, 脊柱, 疼痛, 手术后, 手术后医护, 护理评价研究

Abstract:

Objective To explore the clinical effect of postoperative pain nursing intervention for patients with spinal tuberculosis.Methods A total of 40 patients with spinal tuberculosis who admitted in the Minimally Invasive Spine Surgery Department of the Eighth Medical Center of PLA from January 2016 to June 2017 were randomly selected as the control group, and 40 patients with spinal tuberculosis in the same hospital from July 2017 to January 2019 were randomly included as the observation group. Patients in the control group underwent postoperative routine nursing, and patients in the observation group underwent postoperative pain nursing intervention based on the routine nursing. Then the pain degree and comfort, wound healing time, postoperative hospitalization time, and postoperative complications were compared between the two groups on the 3rd day and 1 week after operation.Results Based on visual analogue scoring (VAS), the pain scores in the observation group were (4.22±0.81) points on the 3rd day after operation and (2.22±0.81) points at 1 week after operation, which were both lower than those in the control group ((4.98±1.12) points and (2.98±1.12) points), with significant statistical differences (t=3.48 and 3.48; P=0.000 and 0.000). The VAS scores of comfort in the observation group were (4.48±0.41) points on the 3rd day after operation and (2.20±0.80) points at 1 week after operation, which were also both lower than those in the control group ((4.92±0.98) points and (2.96±1.12) points), with significant statistical differences (t=2.62 and 3.49; P=0.005 and 0.000). In addition, the postoperative wound healing time ((13.46±1.38) d) and the postoperative hospitalization time ((13.49±1.87) d) in the observation group were both less than those in the control group ((14.76±1.92) d and (14.86±2.54) d), with significant statistical differences (t=3.48 and 2.75; P=0.000 and 0.003). The incidence of postoperative complications in the observation group was lower than that in the control group (5.0%(2/40) vs 25.0%(10/40), χ ²=6.28, P=0.012).Conclusion Postoperative pain nursing intervention for patients with spinal tuberculosis can relieve pain, improve physiological comfort, reduce complications, and promote early recovery and discharge.

Key words: Tuberculosis, spinal, Pain, postoperative, Postoperative care, Nursing evaluation research

艾雅娟,刘向东,毕娜,张颖,张亚茹,罗小波. 脊柱结核患者术后行疼痛护理干预的效果观察[J]. 中国防痨杂志, 2019, 41(10): 1113-1117. doi: 10.3969/j.issn.1000-6621.2019.10.009

Ya-juan AI,Xiang-dong LIU,Na BI,Ying ZHANG,Ya-ru ZHANG,Xiao-bo LUO. Effect of postoperative pain nursing intervention for patients with spinal tuberculosis[J]. Chinese Journal of Antituberculosis, 2019, 41(10): 1113-1117. doi: 10.3969/j.issn.1000-6621.2019.10.009

图/表 3

表1

患者各类临床资料在对照组和观察组间的比较

临床资料	对照组(40例)	观察组(40例)	统计检验值	P值
年龄(岁, $x ˉ$ ±s)	42.35±3.48	42.72±3.11	t=0.50	0.308
性别[例(构成比,%)]			χ²=0.08	0.775
男	8(20.0)	7(17.5)
女	32(80.0)	33(82.5)
患病部位[例(构成比,%)]			χ²=0.80	0.370
胸椎	21(52.5)	17(42.5)
腰椎	19(47.5)	23(57.5)
病灶节段数[例(构成比,%)]			χ²=0.05	0.818
1个	24(60.0)	25(62.5)
2个	16(40.0)	15(37.5)
术前体质量指数( $x ˉ$ ±s)	19.57±2.76	19.16±2.84	t=0.65	0.257
术中出血量(ml, $x ˉ$ ±s)	582.00±122.00	598.00±110.00	t=0.62	0.269
手术时间(min, $x ˉ$ ±s)	320.00±62.00	335.00±56.00	t=1.14	0.129
术前血红蛋白(g/L, $x ˉ$ ±s)	115.29±5.61	116.11±5.14	t=0.68	0.248
切口长度[例(构成比,%)]			χ²=0.85	0.655
<7cm	15(46.9)	17(53.1)
7~10cm	17(48.6)	18(51.4)
>10cm	8(61.5)	5(38.5)
住院时遵医嘱[例(构成比,%)]			χ²=0.16	0.692
是	37(92.5)	36(90.0)
否	3(7.5)	4(10.0)

表1

表2

表3

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