Analysis of the effect of preemptive analgesia combined with nursing intervention on postoperative analgesia for pulmonary tuberculosis

doi:10.19983/j.issn.2096-8493.20220049

Abstract

Abstract:

Objective: To investigate the effect of preemptive analgesia combined with nursing intervention on postoperative analgesia for pulmonary tuberculosis. Methods: A prospective study was conducted in 67 patients with pulmonary tuberculosis who were admitted to Wuhan Pulmonary Hospital from 2020 to 2021 and met the inclusion criteria. All the patients underwent chest surgery. According to the order of single and double numbers during pre-examination on the date of admission, the patients were divided into observation group (n=34, preemptive analgesia nursing) and the control group (n=33, routine nursing),and were placed in group Ⅰ and group Ⅱ of the ward, respectively. The Numerical rating scale,Quality of care satisfaction questionnaire and the Symptoms of the self-assessment scale (SCL-90) were used to compare the postoperative analgesic effect of the two groups, and the occurrence of adverse reactions during the nursing period and the satisfaction with nursing. Results: The incidence of pain after intervention in the observation group (47.1% (16/34)) was significantly lower than that in the control group (51.5% (17/33)), and the nursing satisfaction (88.2% (30/34)) was significantly higher than that of the control group (66.7% (22/33)), the difference were statistically significant (χ²=7.213, P=0.013; χ²=4.483, P=0.031). During the different care interventions, the incidences of defecation difficulty, poor sleep and loss of appetite in the observation group (5.9% (2/34), 8.8% (3/34) and 14.7% (5/34), respectively) were significantly lower than those in the control group (36.4% (12/33), 39.4% (13/33) and 39.4% (13/33)), the difference were statistically significant (χ²=9.413, P=0.001; χ²=9.609, P=0.001; χ²=5.194, P=0.022, respectively). Conclusion: Preemptive analgesia combined with nursing intervention for patients after thoracotomy for tuberculosis has a significant effect on reducing postoperative pain, improving their psychological and living conditions, and improving nursing satisfaction, and has high clinical application value.

Key words: Tuberculosis,pulmonary, Pain,postoperative, Analgesia, Patient medical care

CLC Number:

R473.6

XU Cui-ling, JIANG Yu-hui, XU Fang. Analysis of the effect of preemptive analgesia combined with nursing intervention on postoperative analgesia for pulmonary tuberculosis[J]. Journal of Tuberculosis and Lung Disease , 2022, 3(3): 198-202. doi: 10.19983/j.issn.2096-8493.20220049

Figures/Tables 4

References 20

[1]	禹德富, 梁璃汇, 黄圣杰. 经剑突下入路和经肋间入路单孔胸腔镜肺大疱切除术的临床疗效对比. 局解手术学杂志, 2022, 31(1):48-51. doi: 10.11659/jjssx.07E021045. doi: 10.11659/jjssx.07E021045
[2]	朱璐兰, 刘文和. 按时镇痛护理模式在创伤围手术期的镇痛效果评价. 湘南学院学报(医学版), 2015, 17(3):67-69. doi: 10.16500/j.cnki.1673-498x.2015.03.025. doi: 10.16500/j.cnki.1673-498x.2015.03.025
[3]	Maxwell C, Nicoara A. New developments in the treatment of acute pain after thoracic surgery. Curr Opin Anaesthesiol, 2014, 27(1):6-11. doi: 10.7507/1007-4848.201810052. doi: 10.1097/ACO.0000000000000029 pmid: 24296973
[4]	原晓晖, 蒋筱扬, 汪刚, 等. 右美托咪定联合小剂量氯胺酮预防重度烧伤植皮术瑞芬太尼麻醉后痛觉过敏的效果分析. 实用医院临床杂志, 2022, 19(1):51-55. doi: 10.3969/j.issn.1672-6170.2022.01.013. doi: 10.3969/j.issn.1672-6170.2022.01.013
[5]	王蓓, 雍文成.布托啡诺联合单次椎旁阻滞对行单操作孔电视胸腔镜肺叶切除术肺结核患者镇痛效果及Cor、PGE2和5-HT水平的影响. 中国药师, 2021, 24(5):889-892,945. doi: 10.3969/j.issn.1008-049X.2021.05.019. doi: 10.3969/j.issn.1008-049X.2021.05.019
[6]	罗太君, 高广阔, 李坤, 等.不同胸椎旁神经阻滞方式在胸腔镜肺叶切除术围术期镇痛效果比较. 临床肺科杂志, 2019, 24(7):1188-1192. doi: 10.3969/j.issn.1009-6663.2019.07.007. doi: 10.3969/j.issn.1009-6663.2019.07.007
[7]	蔡宁, 代晨旭, 于海洋, 等. 快速康复外科理念在脊柱后凸畸形矫形术麻醉管理中的应用. 中国医药导报, 2019, 16(22):98-102.
[8]	中华人民共和国国家卫生和计划生育委员会. WS 288-2017 肺结核诊断.2017-11-09.
[9]	中华人民共和国国家卫生和计划生育委员会. WS 196-2017 结核病分类.2017-11-09.
[10]	中华医学会胸心血管外科学分会胸腔镜外科学组, 中国医师协会胸外科医师分会微创外科专家委员会. 中国胸外科围手术期疼痛管理专家共识(2018版). 中国胸心血管外科临床杂志, 2018, 25(11):921-928. doi: 10.7507/1007-4848.201810052. doi: 10.7507/1007-4848.201810052
[11]	Kashefimehr A, Babaloo A, Ghanizadeh M, et al. Effect of prophylactic administration of Novafen for periodontal surgery on postoperative pain relief. J Med Life, 2017, 10(2):127-130. pmid: 28616088
[12]	朱璐兰, 刘文和. 按时镇痛护理模式在创伤围手术期的镇痛效果评价. 湘南学院学报(医学版), 2015, 17(3):67-69. doi: 10.16500/j.cnki.1673-498x.2015.03.025. doi: 10.16500/j.cnki.1673-498x.2015.03.025
[13]	谷晓虹, 梁红霞, 任义, 等.氟比洛芬酯联合罗哌卡因用于预防瑞芬太尼痛觉过敏的临床观察. 山西医药杂志, 2018, 47(12):1431-1432. doi: 10.3969/j.issn.0253-9926.2018.12.025. doi: 10.3969/j.issn.0253-9926.2018.12.025
[14]	陈岷, 李获, 龙恩武, 等.临床药师在骨科围手术期镇痛药物合理使用中的作用. 中国药师, 2018, 21(12):2145-2148. doi: 10.3969/j.issn.1008-049X.2018.12.012. doi: 10.3969/j.issn.1008-049X.2018.12.012
[15]	郭向丽, 赵继军. 疼痛评估的研究进展. 护理学报, 2008, 15(12):8-10. doi: 10.3969/j.issn.1008-9969.2008.12.003. doi: 10.3969/j.issn.1008-9969.2008.12.003
[16]	余洪烈, 王莉, 童华卿, 等. 医护一体化模式对血液透析患者动静脉内瘘的维护作用探讨. 医药前沿, 2019, 9(13):143-144.
[17]	高蜜. 早期康复护理对急性脑卒中偏瘫患者运动功能和生活质量的影响. 实用临床护理学电子杂志, 2020, 5(15):52, 73.
[18]	薛丽珍, 洪丽红. 疼痛护理干预对骨科术后患者疼痛及睡眠的影响. 世界睡眠医学杂志, 2019, 6(11):1593-1595. doi: 10.3969/j.issn.2095-7130.2019.11.041. doi: 10.3969/j.issn.2095-7130.2019.11.041
[19]	刘皓昕, 宁松毅. 多模式镇痛对胆囊切除术病人心理负担与睡眠质量的影响. 安徽医药, 2022, 26(2):394-398. doi: 10.3969/j.issn.1009-6469.2022.02.044. doi: 10.3969/j.issn.1009-6469.2022.02.044
[20]	万琴, 薛庆生, 于布为. 慢性术后疼痛的机制和围术期防治. 中国疼痛医学杂志, 2018, 24(5):367-372. doi: 10.3969/j.issn.1006-9852.2018.05.011. doi: 10.3969/j.issn.1006-9852.2018.05.011

组别	重度疼痛	中度疼痛	轻度疼痛	合计
观察组(34例)	1(2.9)	2(5.9)	13(38.2)	16(47.1)
对照组(33例)	6(18.2)	8(24.2)	3(9.1)	17(51.5)
χ²值	4.157	4.445	7.825	7.213
P值	0.042	0.034	0.011	0.013

组别	非常满意	满意	不满意	满意度
观察组(34例)	20(58.8)	10(29.4)	4(11.8)	30(88.2)
对照组(33例)	13(39.4)	9(27.3)	11(33.3)	22(66.7)
χ²值	4.412	0.038	4.623	4.483
P值	0.032	0.846	0.033	0.031

组别	排便困难	睡眠不良	食欲减退	焦虑心理
观察组(34例)	2(5.9)	3(8.8)	5(14.7)	3(8.8)
对照组(33例)	12(36.4)	13(39.4)	13(39.4)	5(15.2)
χ²值	9.413	9.609	5.194	0.637
P值	0.001	0.001	0.022	0.424