個體化疼痛護理對手術后切口疼痛及止痛藥物用量的影響研究

吳勇飛

【摘要】 目的：探究針對性疼痛護理對甲狀腺手術后切口疼痛及止痛藥物用量的影響。方法：選取筆者所在醫院2018年1月-2019年3月收治的甲狀腺手術后切口疼痛患者102例，采用雙盲法分為甲組和乙組，各51例。甲組采用針對性疼痛護理干預，乙組采用常規護理干預。護理1個月開展隨訪，觀察疼痛評分、舒適感評分、精神健康評分、生活質量評分、止痛藥物用量及不良反應發生情況。結果：甲組疼痛及精神健康評分均低于乙組，舒適感及生活質量評分均高于乙組，差異均有統計學意義（P<0.05）。甲組止痛藥物用量為（64.44±10.05）mg，少于乙組的（98.78±15.69）mg，差異有統計學意義（P<0.05）。甲組不良反應發生率為1.96%，低于乙組的15.69%，差異有統計學意義（P<0.05）。結論：針對性疼痛護理在甲狀腺手術后切口疼痛患者中具有顯著效果，可改善其身心狀態及疼痛感，并減少止痛藥物用量及不良反應，值得應用于臨床推廣。

【關鍵詞】 針對性疼痛護理 甲狀腺手術 切口疼痛 舒適感 不良反應

[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.

甲狀腺是有脊髓動物體內重要腺體之一，直接參與內分泌系統，主要負責調節人體鈣質的平衡狀態[1]。甲狀腺手術是臨床針對甲狀腺疾病患者實施的主要治療措施，通過針對病灶實施切除或清掃來達到治療效果。而治療中，由于手術屬于侵入性操作，外加病灶部位較為特殊，患者術后切口極易產生疼痛感，并對其身心狀態造成影響[2-3]。因此，在甲狀腺手術后應及時輔以護理干預，有效控制其疼痛感及用藥，減少不良反應發生。筆者所在醫院圍繞甲狀腺手術后切口疼痛護理開展研究，整理報道如下。

1 資料與方法

1.1 一般資料

選取筆者所在醫院2018年1月-2019年3月收治的甲狀腺手術后切口疼痛患者102例。納入標準：（1）患者均接受甲狀腺手術治療;（2）經臨床病理學及影像學診斷確診為甲狀腺疾病[4]。排除標準：（1）合并嚴重手術禁忌證;（2）抗拒或抵觸研究;（3）對研究采用止痛藥物成分過敏;（4）合并其他臟器腫瘤;（5）參與其他研究。采用雙盲法分為甲組和乙組，各51例。甲組男26例，女25例，年齡21～70歲，平均（45.4±1.4）歲;乙組男25例，女26例，年齡22～70歲，平均（45.5±1.3）歲。兩組一般資料對比差異無統計學意義（P>0.05）。患者均對本研究知情同意。