脊髓肿瘤患者住院期间疼痛管理方案的构建与应用

Construction and application of pain management plan for patients with spinal cord tumor during hospitalization

中文关键词:  疼痛  脊髓肿瘤  睡眠质量  心理弹性

英文关键词:Pain  Spinal cord tumor  Sleep quality  Resilience

中文摘要:

  【摘要】 目的：构建脊髓肿瘤患者术后疼痛管理方案，为疼痛管理提供科学化、精确化依据。方法：通过循证护理，形成脊髓肿瘤患者住院期间疼痛管理方案初稿，并选取10例患者实施方案初稿，依据实施结果修改完善，形成最终方案。在此基础上，选取2021年1月～2021年7月南京大学医学院附属鼓楼医院神经外科收治的71例脊髓肿瘤患者，采用Excel随机数字生成器随机分为对照组和观察组。对照组采用常规护理干预；观察组在对照组基础上予以疼痛管理方案。比较两组患者术后24h和72h的视觉疼痛模拟评分（visual analog scale，VAS），术后2周的睡眠质量评分（采用匹兹堡睡眠质量评分量表）和心理弹性水平评分（釆用2007年肖楠等翻译修订的中文版心理弹性量表）。结果：术后24h观察组VAS为5.13±2.08分，对照组为5.67±2.22分，差异无统计学意义（P=0.294）；术后72h观察组VAS为3.62±0.92分，对照组为5.12±1.13分，差异有统计学意义（P＜0.001）。术后2周观察组睡眠质量评分为8.80±4.07分，对照组为11.86±4.73分，差异有统计学意义（P=0.005）。术后2周观察组心理弹性水平评分为19.97±11.16分，对照组为17.57±10.21分，差异无统计学意义（P=0.104）。结论：脊髓肿瘤患者疼痛管理方案的应用能够降低患者术后疼痛水平，提高患者的睡眠质量。

英文摘要:

  【Abstract】 Objectives: To construct a postoperative pain management plan for patients with spinal cord tumor and provide a scientific and precise basis for pain management. Methods: The first edition of pain management plan for patients with spinal cord tumor during hospitalization was drafted through evidence-based nursing, and after implenting on 10 patients, the first draft was modified and improved into the final plan according to the implementation results. 71 patients with spinal cord tumor admitted to the Department of Neurosurgery, Drum Tower Hospital, Nanjing University School of Medicine from January 2021 to July 2021 were selected and divided into a control group and an observation group by using Excel random number generator. Patients in the control group were treated with routine nursing intervention after operation, and patients in the observation group were treated with pain management plan. The visual analog scale(VAS) of 24h and 72h after surgery, sleep quality(The Pittsburgh Sleep Quality Index, PSQI) and psychlogical resilience level(the Chinese version of resilience scale translated and revised by XIAO Nan in 2007) 2 weeks after surgery of the two groups of patients were compared. Results: The VAS was 5.13±2.08 in the observation group and 5.67±2.22 in the control group in 24h after operation, the difference was not statistically significant(P=0.294); the VAS in the observation group was 3.62±0.92 and 5.12±1.13 in the control group in 72h after operation, and the difference was statistically significant(P<0.001). In two weeks after operation, the sleep quality score of patients was 8.80±4.07 in the observation group and 11.86±4.73 in the control group, and the difference was significant(P=0.005); And the psychological resilience level score was 19.97±11.16 in the observation group and 17.57±10.21 in the control group, and the difference was not statistically significant(P=0.104). Conclusions: The pain management plan can relieve the postoperative pain of patients with spinal cord tumor and improve the their quality of sleep.