中国胸心血管外科临床杂志

中国胸心血管外科临床杂志

心脏外科术后拔除引流管不同镇痛方法的随机对照试验

查看全文

目的 体外循环下心脏手术后拔除患者心包纵隔引流管时使用不同镇痛方法的效果及满意度比较。 方法 将我院 2017 年 12 月至 2018 年 6 月行体外循环下心脏手术后安置心包纵隔引流管的 94 例患者随机分为 A、B、C 三组,给予不同的处理。A 组:静脉滴注地佐辛注射液,B 组:静脉滴注地佐辛注射液+口服布洛芬缓释胶囊;C 组:静脉滴注地佐辛注射液+口服布洛芬缓释胶囊+拔管护理指导。收集拔管时和拔管后的视觉模拟评分(VAS 评分)、满意度评分及不良反应的发生情况。 结果 B 组患者的疼痛评分和疼痛消失时间低于 A 组患者,B 组的睡眠评分高于 A 组,差异均有统计学意义;C 组患者的疼痛评分和疼痛消失时间明显低于 A 组患者,C 组患者的心情、下床活动和满意度评分均高于 A 组,差异均有统计学意义;C 组患者的下床活动和满意度评分高于 B 组,差异有统计学意义。 结论 地佐辛注射液联合使用布洛芬缓释胶囊在拔除引流管过程中的镇痛效果优于单独使用地佐辛注射液,能减少疼痛,加上专业的护理指导,还能提高患者对临床工作的满意度。

Objectives To compare the effect and degree of satisfaction of different analgesic interventions for tubes of pericardium and mediastinum removal after cardiac surgery. Methods From December 2017 to June 2018, 94 patients undergoing open heart cardiac surgery with tubes of pericardium and mediastinum were allocated randomly into group A, B and C. Group A, intravenous Dezocine was given as analgesics. Group B, intravenous Dezocine plus oral ibuprofen. Group C, interventions of group B plus specific nursing guidance. With the help of visual analogue scale (VAS), scores of pain during and after the tubes removal were collected. The degree of satisfaction and other adverse effects were also recorded. Results The VAS scores and fading time of pain in group B were significantly lower than those of group A. The score of sleeping was better in group B as well. The VAS scores and fading time of pain in group C were also significantly lower than those of group A, and the scores of mood, activity as well as degree of satisfaction were all higher than those in group A. The scores of activity and degree of satisfaction in group C were higher in group C while comparing with group B. Conclusion Combination of intravenous Dezocine and oral ibuprofen seemed to more effective than each individual. Professional and specific nursing guidance could increase the degree of satisfaction for chest tube removal after cardiac surgery.

关键词: 心脏术后; 心包纵隔引流管; 镇痛方法; 满意度

Key words: Post cardiac surgery; tubes of pericardium and mediastinum; analgesic; degree of satisfaction

登录后 ,请手动点击刷新查看全文内容。 没有账号,
登录后 ,请手动点击刷新查看图表内容。 没有账号,
1. Parkin-Smith GF, Norman IJ, Briggs E, et al. A structured protocol of evidence-based conservative care compared with usual care for acute non-specific low back pain:a randomized clinical trial. Arch Phys Med Rehabi, 2012, 93(1): 11-20.
2. 郭海英. 循证护理在胃肠外科管道护理中的应用价值分析. 实用中西医结合临床, 2018, 18(1): 170, 181.
3. 方俊. 地佐辛注射液联合心理干预在肝胆手术术后镇痛中的效果分析. 现代诊断与治疗, 2017, 28(6): 1058-1059.
4. 周超熙, 黄徐晨, 胡旭华, 等. 一种新的处理胃肠外科术后引流管拔除困难的方法:初步经验. 河北医科大学学报, 2017, 38(8): 970-972.
5. 徐建国. 成人术后疼痛治疗进展. 临床麻醉学杂志, 2011, 27(3): 299-301.
6. 徐佳文. 胸外科术后胸腔引流管拔除对胸痛的影响分析. 大家健康(学术版), 2015, (12): 109.
7. Jones CM, Campopiano M, Baldwin G, et al. National and State Treatment Need and Capacity for Opioid Agonist Medication-Assisted Treatment. Am J Public Health, 2015, 105(8): e55-e63.
8. 文芳, 车小乔, 朱永通. 布洛芬缓释胶囊联合护理干预对髋部骨折术后患者疼痛的影响. 中国医药导报, 2014, 11(11): 115-117.
9. 杨艳华. 地佐辛注射液缓解术后疼痛的安全性与有效性临床分析. 贵州医药, 2017, 41(3): 287-289.
10. 林琳, 戢艳丽, 车国卫, 等. 肺癌胸腔镜肺叶切除术后不同药物镇痛效果的随机对照试验. 中国胸心血管外科临床杂志, 2017, 24(11): 830-834.
11. 何建冰, 段红兵, 康健乐, 等. 改良肋间神经冷冻术在胸部术后镇痛中应用的随机对照研究. 中国胸心血管外科临床杂志, 2016, 23(1): 34-37.
12. 相燕, 王烨. 老年人骨折术前与术后疼痛对压疮的影响. 中国保健营养(下旬刊), 2013, 9: 5000-5000.
13. 田野, 艾则孜·阿不都热依木, 赛力克·马高维亚, 等. 深静脉血栓形成患者非手术治疗近期躯体疼痛变化的研究. 中国普通外科杂志, 2012, 21(12): 1500-1504.
14. 胡艳敏, 彭顺秀, 虢新莲, 等. 全程优质护理模式对老年手术病人负性情绪和护理满意度的影响. 全科护理, 2014, (16): 1519-1519, 1524.
15. 钱春荣, 朱京慈, 陈颖峥. 延续护理对脑卒中患者出院后独立生活能力和出院护理满意度的影响. 第三军医大学学报, 2011, 33(8): 841-844.