疼痛護(hù)理干預(yù)路徑對(duì)宮頸癌患者圍手術(shù)期疼痛及負(fù)性情緒影響

吳敏紅　楊惠芬

[摘要] 目的 對(duì)宮頸癌患者圍手術(shù)期采用疼痛護(hù)理干預(yù)路徑護(hù)理，觀察患者圍手術(shù)期疼痛及負(fù)性情緒改善情況。 方法 選取2016年3月～2017年8月入院后確診為宮頸癌患者133例；采取雙盲法，根據(jù)患者確診后病床單雙號(hào)分為對(duì)照組66例與觀察組67例；對(duì)照組予常規(guī)圍手術(shù)期護(hù)理措施，觀察組在對(duì)照組基礎(chǔ)上加行疼痛護(hù)理干預(yù)路徑；比較兩組患者術(shù)前1 d與術(shù)后5 d、10 d NRS疼痛評(píng)分、簡(jiǎn)明疼痛評(píng)估量表評(píng)分，兩組患者術(shù)前1 d與術(shù)后10 d焦慮自評(píng)量表評(píng)分（SAS）、抑郁自評(píng)量表評(píng)分（SDS），兩組患者圍手術(shù)期護(hù)理依從性評(píng)分。 結(jié)果 兩組患者術(shù)前NRS、簡(jiǎn)明疼痛評(píng)估量表評(píng)分均無統(tǒng)計(jì)學(xué)差異（P>0.05），術(shù)后5 d評(píng)分均存在統(tǒng)計(jì)學(xué)意義，且觀察組優(yōu)于對(duì)照組（P<0.05），術(shù)后10 d簡(jiǎn)明疼痛評(píng)估量表評(píng)分存在統(tǒng)計(jì)學(xué)意義，觀察組優(yōu)于對(duì)照組（P<0.05）；兩組患者術(shù)前SAS、SDS評(píng)分無統(tǒng)計(jì)學(xué)差異（P>0.05），術(shù)后5 d、10 d評(píng)分存在統(tǒng)計(jì)學(xué)意義，觀察組優(yōu)于對(duì)照組（P<0.05）；術(shù)后10 d調(diào)查發(fā)現(xiàn)圍手術(shù)期觀察組護(hù)理依從性明顯優(yōu)于對(duì)照組，差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）。 結(jié)論 對(duì)宮頸癌患者圍手術(shù)期采用疼痛護(hù)理干預(yù)路徑能夠有效降低患者負(fù)性情緒，提升患者護(hù)理依從性，且能夠有效減輕患者圍手術(shù)期疼痛程度，值得臨床應(yīng)用與推廣。

[關(guān)鍵詞] 疼痛護(hù)理干預(yù)路徑；宮頸癌；圍手術(shù)期；疼痛評(píng)分；負(fù)性情緒

[中圖分類號(hào)] R473.73 [文獻(xiàn)標(biāo)識(shí)碼] B [文章編號(hào)] 1673-9701（2017）36-0147-04

[Abstract] Objective To investigate the perioperative pain relief and negative mood improvement in patients with cervical cancer by taking pain nursing intervention in cervical cancer patients during periooperative period. Methods A total of 133 patients diagnosed with cervical cancer after admission from March 2016 to August 2017 were enrolled in the study. According to the single and double numbers of patient beds， the patients were divided into control group （n=66） and observation group（n=67） by taking double-blind method. The control group was given conventional perioperative nursing intervention. The patients in the observation group were given pain nursing interventions on the basis of the treatment in the control group. The NRS pain score， concise pain assessment scale score at 1 day before operation and at 5 days after operation， the scores of anxiety self-rating scale （SAS）， depression self-rating scale （SDS） at 1 day before operation， and perioperative nursing compliance scores were compared between the two groups. Results There were no significant differences in preoperative NRS and brief pain assessment scale scores between the two groups（P>0.05）， and the scores at postoperative 5 d between the two groups had statistical significance（P<0.05）. The scores of the observation group were better than those of the control group（P<0.05）. There was statistically significant difference in the between the two groups on the 10th day after the operation， and the brief pain assessment scale score of the observation group was better than that of the control group（P<0.05）. The preoperative SAS， SDS scores had no significant difference between the two groups（P>0.05）. There were significant differences in scores at postoperative 5 d and 10 d， and the scores in observation group was better than that of the control group（P<0.05）. The survey at 10 d after surgery found that perioperative nursing compliance in the observation group was significantly better than that in the control group， and the data was statistically significant（P<0.05）. Conclusion Perioperative nursing interventions for cervical cancer patients can effectively reduce the negative emotions， improve patient care compliance， and can effectively reduce the perioperative pain in patients， which is worthy of clinical application and promotion.

[Key words] Pain nursing intervention pathway； Cervical cancer； Perioperative period； Pain score； Negative emotion

宮頸癌發(fā)病率是婦科惡性腫瘤中首位，對(duì)宮頸癌的治療方法最主要的為早期手術(shù)[1]。宮頸癌患者圍手術(shù)期的精神癥狀主要表現(xiàn)為焦慮、抑郁，這與惡性腫瘤的發(fā)生、患者存活時(shí)間、心理因素、社會(huì)支持等方面因素相關(guān)[2]。隨著人們物質(zhì)生活水平的不斷提升，人們對(duì)于疾病的治療不再局限于生理層面，更加需要精神層面的恢復(fù)[3]，因此，針對(duì)宮頸癌患者圍手術(shù)期負(fù)性情緒的改善，成為了治療宮頸癌的第二目標(biāo)。我院就針對(duì)宮頸癌患者開展了疼痛護(hù)理干預(yù)路徑，觀察其對(duì)患者圍手術(shù)期疼痛及負(fù)性情緒的影響，取得肯定研究結(jié)局，現(xiàn)報(bào)道如下。