目的 探讨基于循证理论的疼痛护理对输尿管结石微创手术患者术后疼痛及康复的影响,以期为优化该类患者的护理服务提供参考依据.方法 选取2015年8月至2017年6月在本院泌尿外科行微创手术治疗的输尿管结石患者136例,按随机数字表法分为观察组和对照组,每组68例,对照组患者接受泌尿外科围术期常规护理,观察组患者则接受基于循证理论的疼痛护理.分别于术后第1、3、5天采用视觉模拟评分法(VAS)评估两组患者疼痛程度,术后第5天采用休斯顿疼痛情况调查表(HPOI)调查两组患者疼痛控制满意度.详细记录两组患者术后感染、术后出血的发生率及术后下床活动时间、住院时间.结果 观察组患者术后第1、3、5天VAS评分明显低于对照组患者,差异有显著性(P<0.05).术后第5天观察组HPOI量表中"疼痛期望"、"疼痛经历"、"疼痛对情绪的影响"、"疼痛对日常生活的影响"等维度的评分明显低于对照组患者,而"疼痛控制感知状态"、"疼痛控制教育感知状况"评分明显高于对照组患者,差异均有显著性(P<0.05).观察组患者术后下床活动时间、住院时间均明显短于对照组患者,差异有显著性(P<0.05),但术后感染、术后出血发生率两组比较差异无显著性(P>0.05).结论 基于循证理论的疼痛护理可显著缓解输尿管结石微创手术后的疼痛,提高患者疼痛控制满意度,有利于促进术后康复.%Objective To investigate the effect of pain nursing based on evidence-based theory on postoperative pain and rehabilitation for patients with ureteral calculi minimally invasive surgery, in order to provide reference for optimizing the nursing service of the patients. Method 136 cases of patients with ureteral calculi received minimally invasive surgery in our hospital between August 2015 to June 2017 were selected and randomly divided into experimental group and control group, each of 68 cases. Patients on control group received urological perioperative routine care and patients on experimental group received pain nursing based on evidence-based theory. The pain condition were evaluated by visual analogue scale (VAS) at 1, 3, 5 days after operation, and the pain control satisfaction were evaluated by Houston pain outcome instrument (HPOI) at 5 days after operation. The incidence of postoperative infection, postoperative bleeding and postoperative ambulation time, hospitalization time were recorded. Result The VAS scores of experimental group were significantly lower than that of control group at 1, 3, 5 days after operation (P<0.05); The scores of "pain expectation", "pain experience", "impact of pain on emotions", "impact of pain on daily life" of experimental group were significantly lower than that of control group (P<0.05), and the scores of "pain control perception state", "pain control education perception" of experimental group were significantly higher than that of control group (P<0.05). The postoperative ambulation time, hospitalization time of experimental group were significantly shorter than those in the control group (P<0.05), and there were no statistically significant difference on incidence of postoperative infection, postoperative bleeding between the two groups (P>0.05). Conclusion Pain nursing based on evidence-based theory can significantly relieve the pain of patients with ureteral calculi received minimally invasive surgery, improve the pain control satisfaction, be helpful to promote postoperative rehabilitation.
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