剖宫产切口妊娠患者子宫动脉栓塞术后疼痛相关因素分析
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摘要
目的探讨剖宫产切口妊娠患者子宫动脉栓塞术后疼痛发生情况及其影响因素。方法对120例剖宫产切口妊娠患者在子宫动脉栓塞术后0、6、12、24h,采用数字疼痛评分法进行疼痛评估,收集疼痛相关因素(如术前测量疼痛敏感度、人口统计学资料及焦虑、抑郁等)。结果术后24h内中度及以上疼痛占58.33%;单因素分析显示,心理状态、疼痛敏感度、文化程度及手术时长是剖宫产切口妊娠患者子宫动脉栓塞术后中度及以上疼痛的相关因素(P<0.05,P<0.01)。结论子宫动脉栓塞术后疼痛发生率高,术前充分评估患者心理状态和实验性压力痛阈测试可用来预测术后患者疼痛,从而更好地管理和控制疼痛。
Objective To describe the incidence of pain in women with cesarean scar pregnancy(CSP)after uterine artery embolization(UAE)and to explore the influencing factors.Methods Pain intensity of 120 CSP women was assessed at immediately after and 6,12 and 24hafter UAE using the Numerical Rating Scale.And the related factors were also collected including pain sensitivity measured preoperatively,demographic data,anxiety and depression,etc..Results Nearly sixty percent(58.33%)of the women had moderate to severe pain.Mental state,pain sensitivity,education level and operation duration were related factors of moderate to severe pain after UAE(P<0.05,P<0.01).Conclusion The prevalence of pain was high in CSP women after UAE.Preoperative mental state assessment and pressure pain threshold test can predict postoperative pain intensity,thus to achieve better pain management and control.
Objective To describe the incidence of pain in women with cesarean scar pregnancy(CSP)after uterine artery embolization(UAE)and to explore the influencing factors.Methods Pain intensity of 120 CSP women was assessed at immediately after and 6,12 and 24hafter UAE using the Numerical Rating Scale.And the related factors were also collected including pain sensitivity measured preoperatively,demographic data,anxiety and depression,etc..Results Nearly sixty percent(58.33%)of the women had moderate to severe pain.Mental state,pain sensitivity,education level and operation duration were related factors of moderate to severe pain after UAE(P<0.05,P<0.01).Conclusion The prevalence of pain was high in CSP women after UAE.Preoperative mental state assessment and pressure pain threshold test can predict postoperative pain intensity,thus to achieve better pain management and control.
引文
[1]叶青剑,邓佩霞,沈晓婷,等.子剖宫产切口瘢痕妊娠分析[J].中山大学学报(医学科学版),2017,38(4):596-600.
[2]陶美霞.分析剖宫产术后子宫切口妊娠的超声表现及治疗观察[J].中国现代药物应用,2017,11(11):132-133.
[3]王靖辉,刘玉侠,郭海鸥.子宫动脉灌注栓塞术在宫颈妊娠或子宫下段切口妊娠中的应用[J].宁夏医科大学学报,2010,32(1):114.
[4]周萍.子宫动脉化疗灌注加栓塞术终止子宫切口妊娠的护理[J].护理学杂志,2007,22(6):48-49.
[5]胡雅芬,贺爱红,刘晓,等.子宫动脉栓塞术后并发症的观察和护理276例[J].中国实用护理杂志,2006,22(20):38-39.
[6]李慧,朱柏宁.子宫肌瘤介入栓塞术后疼痛原因分析及护理[J].当代护士,2007(9):29-30.
[7]杨凌艳,傅玲.凶险性前置胎盘行双侧髂内动脉球囊预置剖宫产术患者的护理[J].护理学杂志,2017,32(18):52-54.
[8]陈祢,郭铁成,许惊飞,等.手持式压力测痛仪的信度及效度检验[J].中华物理医学与康复杂志,2009,31(10):690-693.
[9]段泉泉,胜利.焦虑及抑郁自评量表的临床效度[J].中国心理卫生杂志,2012,26(9):676-679.
[10]朱秀芳,马冬梅,黄丽丽,等.12例子宫剖宫产瘢痕处妊娠子宫动脉栓塞术治疗的护理[J].中华护理杂志,2007,42(11):1022-1023.
[11]Ravn P,Frederiksen R,Skovsen A P,et al.Prediction of pain sensitivity in healthy volunteers[J].J Pain Res,2012,5(1):313-326.
[12]陈佳佳,童莺歌,柴玲,等.中文版多维疼痛评估工具的比较分析[J].护理学杂志,2018,33(6):102-105.
[13]Nielsen C S,Stubhaug A,Price D D,et al.Individual differences in pain sensitivity:genetic and environmental contributions[J].Pain,2008,136(1-2):21-29.
[14]Hinrichs-Rocker A,Schulz K,Jrvinen I,et al.Psychosocial predictors and correlates for chronic postsurgical pain(CPSP)-a systematic review[J].Eur J Pain,2009,13(7):719-730.
[15]Kaunisto M A,Jokela R,Tallgren M,et al.Pain in 1000women treated for breast cancer:aprospective study of pain sensitivity and postoperative pain[J].Anesthesiology,2013,119(6):1410-1421.
[16]Johansen A,Schirmer H,Stubhaug A,et al.Persistent post-surgical pain and experimental pain sensitivity in the Tromsstudy:comorbid pain matters[J].Pain,2014,155(2):341-348.
[17]杨利芬.中医综合护理方案干预腹部手术患者术前焦虑抑郁的临床研究[J].辽宁中医杂志,2015,42(3):625-627.
[18]张卫,常琰子,阚全程,等.术前焦虑状态对妇科手术患者痛阈和耐痛阈的影响[J].中华麻醉学杂志,2009,29(3):210-211.
[19]陈晓琳,丁娟,朱赟.前列腺癌患者术前焦虑与术后疼痛的相关性分析[J].中国临床医学,2012,19(3):278-279.
[20]林飞飞,叶傲霜,徐怡,等.术前抑郁对腹式子宫次全切手术患者术后疼痛的影响[J].安徽医学,2013,34(9):1365-1366.
[21]陈小婉,杨贵军,李爽,等.鼻内镜患者术前焦虑与术后疼痛程度临床观察[J].临床耳鼻咽喉头颈外科杂志,2014,28(23):1832-1834.
[22]周志强,李佐凡,陈躐,等.无痛胃镜患者疼痛敏感度相关因素调查[J].临床外科学杂志,2016,24(5):381-383.
[23]王宁华.实验痛评测方法之一:压痛阈[J].国外医学物理医学与康复医学分册,2004,24(3):97.
[24]Strulov L,Zimmer E Z,Granot M,et al.Post cesarean pain prediction by preoperative experimental pain assessment[J].Anesthesiology,2003,98(6):1422-1426.
[25]杨远东,张灵敏,袁慧,等.试验性疼痛测试与术后疼痛的关系[J].西安交通大学学报(医学版),2014,35(4):494-498.
[26]谢冰柯,许乐.腹部手术患者疼痛信念的调查研究[J].护理学杂志,2008,23(10):18-19.
[27]倪娟,陈筱静,罗林丽,等.影响妇科腹腔镜手术术后疼痛的相关因素研究[J].现代预防医学,2012,39(7):1632-1633,1636.
[28]王丽鸽,郝银.子宫动脉栓塞术后腹痛的原因分析及护理[J].基层医学论坛,2011,15(1):44-45.
[2]陶美霞.分析剖宫产术后子宫切口妊娠的超声表现及治疗观察[J].中国现代药物应用,2017,11(11):132-133.
[3]王靖辉,刘玉侠,郭海鸥.子宫动脉灌注栓塞术在宫颈妊娠或子宫下段切口妊娠中的应用[J].宁夏医科大学学报,2010,32(1):114.
[4]周萍.子宫动脉化疗灌注加栓塞术终止子宫切口妊娠的护理[J].护理学杂志,2007,22(6):48-49.
[5]胡雅芬,贺爱红,刘晓,等.子宫动脉栓塞术后并发症的观察和护理276例[J].中国实用护理杂志,2006,22(20):38-39.
[6]李慧,朱柏宁.子宫肌瘤介入栓塞术后疼痛原因分析及护理[J].当代护士,2007(9):29-30.
[7]杨凌艳,傅玲.凶险性前置胎盘行双侧髂内动脉球囊预置剖宫产术患者的护理[J].护理学杂志,2017,32(18):52-54.
[8]陈祢,郭铁成,许惊飞,等.手持式压力测痛仪的信度及效度检验[J].中华物理医学与康复杂志,2009,31(10):690-693.
[9]段泉泉,胜利.焦虑及抑郁自评量表的临床效度[J].中国心理卫生杂志,2012,26(9):676-679.
[10]朱秀芳,马冬梅,黄丽丽,等.12例子宫剖宫产瘢痕处妊娠子宫动脉栓塞术治疗的护理[J].中华护理杂志,2007,42(11):1022-1023.
[11]Ravn P,Frederiksen R,Skovsen A P,et al.Prediction of pain sensitivity in healthy volunteers[J].J Pain Res,2012,5(1):313-326.
[12]陈佳佳,童莺歌,柴玲,等.中文版多维疼痛评估工具的比较分析[J].护理学杂志,2018,33(6):102-105.
[13]Nielsen C S,Stubhaug A,Price D D,et al.Individual differences in pain sensitivity:genetic and environmental contributions[J].Pain,2008,136(1-2):21-29.
[14]Hinrichs-Rocker A,Schulz K,Jrvinen I,et al.Psychosocial predictors and correlates for chronic postsurgical pain(CPSP)-a systematic review[J].Eur J Pain,2009,13(7):719-730.
[15]Kaunisto M A,Jokela R,Tallgren M,et al.Pain in 1000women treated for breast cancer:aprospective study of pain sensitivity and postoperative pain[J].Anesthesiology,2013,119(6):1410-1421.
[16]Johansen A,Schirmer H,Stubhaug A,et al.Persistent post-surgical pain and experimental pain sensitivity in the Tromsstudy:comorbid pain matters[J].Pain,2014,155(2):341-348.
[17]杨利芬.中医综合护理方案干预腹部手术患者术前焦虑抑郁的临床研究[J].辽宁中医杂志,2015,42(3):625-627.
[18]张卫,常琰子,阚全程,等.术前焦虑状态对妇科手术患者痛阈和耐痛阈的影响[J].中华麻醉学杂志,2009,29(3):210-211.
[19]陈晓琳,丁娟,朱赟.前列腺癌患者术前焦虑与术后疼痛的相关性分析[J].中国临床医学,2012,19(3):278-279.
[20]林飞飞,叶傲霜,徐怡,等.术前抑郁对腹式子宫次全切手术患者术后疼痛的影响[J].安徽医学,2013,34(9):1365-1366.
[21]陈小婉,杨贵军,李爽,等.鼻内镜患者术前焦虑与术后疼痛程度临床观察[J].临床耳鼻咽喉头颈外科杂志,2014,28(23):1832-1834.
[22]周志强,李佐凡,陈躐,等.无痛胃镜患者疼痛敏感度相关因素调查[J].临床外科学杂志,2016,24(5):381-383.
[23]王宁华.实验痛评测方法之一:压痛阈[J].国外医学物理医学与康复医学分册,2004,24(3):97.
[24]Strulov L,Zimmer E Z,Granot M,et al.Post cesarean pain prediction by preoperative experimental pain assessment[J].Anesthesiology,2003,98(6):1422-1426.
[25]杨远东,张灵敏,袁慧,等.试验性疼痛测试与术后疼痛的关系[J].西安交通大学学报(医学版),2014,35(4):494-498.
[26]谢冰柯,许乐.腹部手术患者疼痛信念的调查研究[J].护理学杂志,2008,23(10):18-19.
[27]倪娟,陈筱静,罗林丽,等.影响妇科腹腔镜手术术后疼痛的相关因素研究[J].现代预防医学,2012,39(7):1632-1633,1636.
[28]王丽鸽,郝银.子宫动脉栓塞术后腹痛的原因分析及护理[J].基层医学论坛,2011,15(1):44-45.