腹腔镜胆囊手术后颈肩痛的护理干预

目的：探讨腹腔镜胆囊手术后引发颈肩痛的护理干预措施,以降低腹腔镜胆囊手术后颈肩痛的发生率和减轻术后颈肩痛的程度。方法：将我院2001年5月～2004年4月住院的90例行腹腔镜胆囊手术的患者作为对照组,将2004年5月～2007年12月住院的114例行腹腔镜胆囊手术的患者作为实验组,实验组采取适当调节气腹压力、改变手术体位、术后尽量排出残余气体、术后持续吸氧等护理干预措施,观察颈肩痛发生情况。结果：两组术后颈肩痛发生率比较,P〈0.001。结论：适当调节气腹压力、改变手术体位、术后尽量排出残余气体、术后持续吸氧等护理措施能有效预防及减轻腹腔镜胆囊手术后的颈肩痛。     

循证护理在预防腹腔镜手术发生颈肩痛中的应用

腹腔镜手术由于创伤小,恢复快,术后疼痛轻等特点,在外科手术中已被普遍采用.但腹腔镜手术需充二氧化碳建立气腹,且维持一定的压力才能清楚显示手术野.文献报道[1],腹腔镜手术尤其是腹腔镜下胆囊切除术后发生颈肩痛十分常见,其发生率为30%～40%,也有高达80%的报道.为了降低患者颈肩痛的发生率,减轻颈肩痛的程度,作者进行了循证护理,通过合理调节气腹压力,及时调整手术体位,延长吸氧时间等护理措施,使颈肩痛的发生降到最低程度,取得了较好的临床效果,现报道如下.     

护理干预对妇科腹腔镜术后患者非切口疼痛的影响

目的探讨腹腔镜手术术后非切口疼痛的相关因素,进行针对性护理干预,以降低腹腔镜手术术后疼痛程度。方法将腹腔镜手术患者分为两组对照研究。对照组为传统方法行腹腔镜手术术前及术后护理资料。实验组采取合理调节气腹压力、术后平卧位、延长吸氧时间并鼓励早期活动等护理干预措施,观察非切口痛发生情况及程度。结果两组术后非切口痛发生率比较及VAS评分差异有统计学意义（P〈0．01）。结论术中采取合理调节气腹压力、术后采取平卧位、延长吸氧时间并鼓励早期活动等护理措施能有效减轻腹腔镜手术术后非切口疼痛。     

调整二氧化碳气腹压力对妇科腹腔镜手术后肩痛的影响

目的:探讨二氧化碳(CO2)气腹压力对妇科腹腔镜手术后肩痛的影响。方法:选取2013年1～6月我院行妇科腹腔镜手术患者80例,随机等分为两组,对照组常规手术,CO2气腹压力14 mmHg;试验组采取调节CO2气腹压力10 mmHg,观察两组颈肩痛发生情况和颈肩痛程度。结果:两组手术时间比较无统计学意义,试验组CO2用气量明显减少,颈肩痛发生率低于对照组。结论:合理调节气腹压力能有效减少CO2用气量,减轻妇科腹腔镜手术肩痛的发生率。     

妇科腹腔镜术后肩背痛的原因分析及护理对策

目的 分析妇科腹腔镜术后肩背痛的发病因素,探讨护理干预措施对腹腔镜术后的效果。 方法 将201例腹腔镜术后患者分为观察组101例与对照组100例。对照组术后吸氧2h,平卧位或半卧位;观察组术后吸氧10h,采取术后半卧位或半坐卧位,肩背部和季肋部按摩等护理措施。观察两组术后肩背痛发生率、疼痛持续时间和疼痛程度。 结果 实验组发生肩背痛人数较对照组少(χ²=28.398,P＜0.01),发生肩背痛持续时间较对照组短(t=3.34,P＜0.05)。两组术后肩背痛疼痛程度比较,实验组轻于对照组(χ²=18.27,P＜0.05)。 结论 延长术后吸氧时间,采取半卧位或半坐卧位,行肩背部和季肋部按摩等护理措施,可有效减少腹腔镜术后肩背部疼痛的发生及减轻疼痛程度。     

腹腔镜胆囊切除术后颈肩痛原因分析及护理

目的观察腹腔镜胆囊手术(LC)后颈肩痛的成因及相关护理干预。方法选择行腹腔镜胆囊手术的患者64例,随机分为观察组和对照组,采用不同方法行腹腔镜胆囊切除术并实施不同护理手段,比较2组患者的颈肩痛发生率及康复时间。结果观察组的颈肩痛发生率比对照组低,恢复时间比对照组短,差异有统计学意义(P0.05)。结论降低CO_2气腹压力、改变手术体位、排出余气、持续吸氧、心理护理手段都能有效降低颈肩痛发生率和缩短康复时间,值得临床推广应用。     

循证护理在预防腹腔镜手术发生颈肩痛中的应用

腹腔镜手术由于创伤小，恢复快，术后疼痛轻等特点，在外科手术中已被普遍采用。但腹腔镜手术需充二氧化碳建立气腹，且维持一定的压力才能清楚显示手术野。文献报道，腹腔镜手术尤其是腹腔镜下胆囊切除术后发生颈肩痛十分常见，其发生率为30％～40％，也有高达80％的报道。为了降低患者颈肩痛的发生率，减轻颈肩痛的程度，作者进行了循证护理，     

体位和气腹压力对腹腔镜术后肩痛的影响

目的 探讨腹腔镜不同手术体位和气腹压力对术后肩痛的影响.方法 随机选择腹腔镜手术277例,术中采取头高足低位142例,气腹压力设定A组14 mm Hg,B组10 mm Hg.头低足高位135例,气腹压力设定C组14 mm Hg,D组10 mm Hg.比较4组患者术后肩痛的发生率.结果 两种手术体位对术后肩痛发生率有显著差异(P<0.05),低气腹压力组术后肩痛发生率明显低于高气腹压力组.结论 体位和气腹压力均对腹腔镜术后肩痛有影响,高气腹压力或头低足高位可致腹腔镜术后肩痛.     

腹腔镜患者术后颈肩痛的原因分析及护理对策

在腹腔镜手术后患者通常会出现颈肩痛的现象。颈肩痛原因通常与患者的体位因素、气腹因素有所关联,护理对策主要采用排除气体、术后疼痛部位按摩以及采用正确体位。本研究针对这些原因进行分析,并采取正确的手术体位和持续吸氧治疗,以促进患者疼痛症状的有效缓解,为临床提供参考依据。     

综合护理干预对妇科腹腔镜术后并发症的效果观察

目的:探讨妇科腹腔镜术后综合护理干预的效果。方法:将108例妇科腹腔镜手术患者随机分为对照组和观察组,对照组采用常规护理干预方法,观察组则采用综合护理干预,包括术中调节气腹压力、术后6 h膝胸卧位、早期床上运动及功能康复操的锻炼。结果:观察组术后CO2气腹并发症包括恶心、呕吐、腹胀、腹痛、肩痛、膈下疼痛等发生率低于对照组,差异有统计学意义(P<0.01或P<0.05)。结论:综合护理干预可显著降低CO2气腹并发症的发生,促进排气、排便,优于常规护理干预。     

Fear of pain in orofacial pain patients

In the present study, we examined whether fear of pain, dental fear, general indices of psychological distress, and self-reported stress levels differed between 40 orofacial pain patients and 40 gender and age matched control general dental patients. We also explored how fear of pain, as measured by the Fear of Pain Questionnaire-III (J Behav Med 21 (1998) 389), relates to established measures of psychological problems in our sample of patients. Finally, we examined whether fear of pain uniquely and significantly predicts dental fear and psychological distress relative to other theoretically-relevant psychological factors. Our results indicate that fear of severe pain and anxiety-related distress, broadly defined, are particularly elevated in orofacial pain patients relative to matched controls. Additionally, fear of pain shares a significant relation with dental fear but not other general psychological symptomology, and uniquely and significantly predicts dental fear relative to other theoretically-relevant variables. Taken together, these data, in conjunction with other recent studies, suggest greater attention be placed on understanding the fear of pain in orofacial pain patients and its relation to dental fear and anxiety.     

From past pain to future pain through the pain of others: Information about other people's pain ratings can alleviate our subsequent pain

Background

Previous studies have shown that pain memories have a profound impact on subsequent pain experiences. This study investigated whether pain ratings derived from other people can modify an individual's memory of past pain. This study also examined whether pain memory modified by others' pain ratings determines subsequent pain experiences.

Methods

Participants were divided into two groups: an experimental group and a control group. Participants in both groups were exposed to pain stimulation; then, they recalled its intensity twice over a period of time; after a break, they were again exposed to pain stimulation of the same intensity. The final sample consisted of 53 participants. The only difference between the experimental group and the control group was that in the former the pain ratings of other alleged participants were presented between the two consecutive pain recalls. These ratings suggested that other people experienced the same pain as less intense.

Results

The pain ratings derived from other people did not alter the pain memory; nevertheless, they affected an individual's next pain experience even for a certain period of time after their presentation. This type of pain-related information shaped participants' subsequent pain experiences regardless of their empathy, conformity, and susceptibility to social influence.

Conclusions

Information on pain derived from other people not only shapes the response to a novel stimulation but also substantially modifies the subsequent experience of that stimulation.

Significance

The study demonstrates the importance of social information on pain and provides evidence that this type of information substantially modifies the subsequent experience of the same pain. These results suggest that social information on pain can be used to alleviate pain associated with recurring medical procedures and thus increase patients' willingness to continue treatment.     

Electronic momentary assessment in chronic pain II: pain and psychological pain responses as predictors of pain disability

OBJECTIVES AND METHODS: More than 7,100 electronic diaries from 80 patients with chronic pain (mean: 89.3, range 30-115) entered multilevel analyses to establish the statistical prediction of disability by pain intensity and by psychological functioning (fear avoidance, cognitive, and spousal pain responses). We also tested the differences between pre-chronic, recently chronic, and persistently chronic pain in the prediction of disability (impaired physical and mental capacity, pain interference with activities, immobility due to pain). RESULTS: Pain intensity explained 8% to 19% of the disability variance. Beyond this psychological functioning explained 7% to 16%: particularly fear-avoidance and cognitive pain responses predicted chronic pain disorder disability; spousal responses predicted immobility better than other aspects of disability. Immobility due to actual pain occurred infrequently. When it did, however, it was better predicted by avoidance behavior in the patient and by spousal discouragement of movement than by actual pain intensity. The prediction of immobility due to pain by, respectively, avoidance behavior and catastrophizing was better in chronic pain (>6 months) and that of physical impairment by catastrophizing better in persistently chronic pain (>12 months) than in pain of shorter duration. DISCUSSION: The psychological prediction of chronic pain disorder disability was determined beyond that accounted for by pain intensity. Nonetheless, psychological functioning explained substantial variance in chronic pain disorder disability. The psychological prediction of immobility and physical impairment was stronger with longer pain duration. Patient characteristics and momentary states of disability-and in particular of immobility-should be carefully distinguished and accounted for in chronic pain disorder.     

无痛静脉穿刺技术的研究进展

静脉穿刺技术是临床上常用的基础护理操作技术，可通过静脉给药而达到治疗疾病的目的，而穿刺同时引起的疼痛同样令人难以忍受。疼痛是人的一种生理、心理感受，是在实际上或潜在因素造成组织损伤的情感经历。疼痛不只是主观上使人感觉不适，客观上还能引起病人生命体征的改变，打针痛已成为人们脑海里固有的概念，患儿则常以哭闹的方式拒绝穿刺。因此，如何减轻静脉穿刺引起的疼痛，一直成为护理同仁们研究的课题，现就无痛静脉穿刺的方法及技术进展综述如下。     

Role of pain management programmes in chronic pain

Many people in the UK experience chronic pain. This can have a huge effect on a person's life, including their mood, work and family. Pain management programmes are proving effective in helping people to cope with pain and improve their quality of life.