居家癌痛管理APP软件的研制及应用评价

目的探讨护患APP在居家癌性疼痛患者中的应用效果。方法将80例出院癌痛患者随机分为对照组和观察组各40例,对照组实施常规出院后电话随访,观察组通过护患APP进行居家癌痛管理,出院3周后比较两组患者服药依从性、镇痛效果、满意度及疼痛评分。结果观察组患者服药依从性、镇痛效果、满意度显著高于对照组,疼痛评分显著低于对照组(P0.05,P0.01)。结论通过护患APP进行居家患者癌痛管理,可提高患者的遵医行为及镇痛满意度。     

疼痛全程管理对癌痛患者服药依从性及爆发痛的影响

目的降低癌痛患者爆发痛发生率。方法将200例癌痛患者根据入院时间分组,2014年1~12月收治的癌痛患者100例分为对照组,2015年1~12月收治的癌痛患者100例分为干预组,两组均按癌痛规范化治疗,对照组行常规护理及健康指导,干预组实施疼痛全程管理模式干预,比较两组服药依从性及爆发痛发生率。结果干预后干预组服药依从性显著高于对照组(P0.01),而爆发痛发生率显著低于对照组(P0.01)。结论全程护理管理模式是一种全程化、专业化、人性化的护理模式,用于癌症晚期患者的疼痛管理,能有效提高患者服药依从性,减少癌性爆发痛的发生,提高癌痛患者生活质量。     

赋能教育在癌痛患者中的应用

目的探讨赋能教育对癌痛患者疼痛控制的影响。方法将80例癌痛患者随机分为干预组与对照组各40例,对照组给予常规癌痛知识教育,干预组在此基础上结合赋能教育进行干预。观察两组癌痛患者在出院后4周服药依从性、癌性爆发痛发生率、癌痛控制障碍得分及疼痛应对策略得分情况。结果出院后4周干预组服药依从性及疼痛应对策略评分显著高于对照组,爆发痛发生率及癌痛控制障碍得分显著低于对照组(P 0. 05,P 0. 01)。结论对癌痛患者实施赋能教育能提高患者的服药依从性,减少癌性爆发痛发生率,减轻患者癌痛控制障碍,有利于患者采取积极的应对策略,从而更好地控制癌痛。     

医护药一体化管理在癌痛患者中的应用

目的探讨医护药一体化管理在癌痛患者中的应用效果。方法按时间段将91例恶性肿瘤疼痛患者分为对照组44例、观察者47例;对照组行常规癌痛管理,观察组成立医护药一体化癌痛管理小组实施协同管理。结果观察组镇痛药服药依从性显著高于对照组,疼痛评分显著低于对照组(P 0. 05,P 0. 01)。结论对癌痛患者实施医护药一体化管理,可有效提高患者镇痛药服药依从性,从而有效缓解疼痛。     

微信平台在腕管综合征患者术后康复训练中的应用效果

目的探讨微信平台在腕管综合征患者术后康复训练中的应用效果。方法随机抽样选择2018年5月-2019年5月120例行腕管综合征手术治疗的患者,采用随机数字表法分为观察组和对照组,各60例。对照组采用常规电话随访,观察组建立微信群,定期发布腕管综合征术后康复知识,制定不同阶段康复训练计划,并接受答疑解惑。90 d后对比两组患者出院后的康复训练依从性、麻痛数值评分(numbness numerical score, NRS)、握力改善分数及患者满意度等。结果术后第90天,观察组的康复训练依从性、握力改善分数及满意度均优于对照组,NRS评分低于对照组,差异有统计学意义(P 0.01)。结论微信平台的应用可明显提高腕管综合征患者术后康复训练依从性,从而缓解患者麻痛症状,促进患肢的功能改善,提高患者对医护人员的满意度。     

用药教育对癌痛患者口服镇痛药物治疗效果影响

目的:了解用药教育对减轻患者对疼痛治疗的顾虑、提高用药依从性,从而提高疼痛治疗的有效性.方法:对48例癌痛患者进行镇痛药物知识宣教,对比干预前后患者对疼痛治疗的认识和行为的变化及患者的疼痛缓解程度变化.结果:与癌痛教育前比较,教育后患者对癌痛治疗的错误认识与行为水平明显战低(P<0.01);疼痛明显缓解的患者比例增加(P<0.01).结论:进行癌痛知识健康宣教,可明显减轻患者对疼痛治疗的顾虑.提高其治疗依从性,从而保证疼痛治疗的顺利进行,对临床癌痛控制起积极的促进作用.     

微信平台延伸护理服务对前牙缺损纳米复合树脂修复术后患者疼痛、美观度及复诊率的影响

目的：分析微信平台延伸护理服务对前牙缺损纳米复合树脂修复术后患者疼痛、美观度及复诊率的影响。方法：选择2020年11月-2021年12月笔者科室收治的76例前牙牙体缺损患者为研究对象，采用随机数字表法分为对照组（38例）和观察组（38例）。所有患者均进行纳米复合树脂修复，对照组采用常规护理，观察组在对照组基础上采用微信平台的延伸护理服务，两组均干预至修复后6个月。统计两组临床疗效、疼痛程度、生活质量、口腔修复依从性、修复美观度、修复后舒适度、满意度、复诊及并发症发生情况等。结果：干预结束后，观察组总有效率高于对照组（P<0.05），观察组心理状况、生理状况、社会关系、环境评分高于对照组（P<0.05），观察组口腔修复依从性、修复后美观度、修复后舒适度及患者对外观修复满意度、功能修复满意度、医生对护理配合满意度评分均高于对照组（P<0.05）。修复后1周及修复后1、3、6个月，观察组疼痛评分低于对照组（P<0.05）。修复后1、3、6个月，观察组复诊率均高于对照组（P<0.05）；随访期间，观察组总并发症发生率低于对照组（P<0.05）。结论：采用微信...     

微信公众号在整形美容患者围手术期护理中的应用

目的:探讨微信公众号在整形美容患者围手术期护理工作中的应用方法及效果。方法:选取2017年1月-8月在笔者科室行整形美容手术的100例女性患者,随机分为对照组和观察组,每组50例。对照组采用传统的术前、术后健康教育;观察组在对照组健康教育的基础上,利用微信公众平台对患者进行术前宣教、术后指导、咨询。比较两组患者对术前宣教、术后注意事项的掌握程度,焦虑情况和护理工作的满意度。结果:观察组患者对宣教内容的掌握程度和对护理工作的满意度明显高于对照组,焦虑情况低于对照组,差异具有统计学意义(P0.05)。结论:应用微信公众号对整形美容患者进行围手术期护理,可提高患者掌握相关知识知晓率,能够有效减轻患者焦虑情绪,提高患者满意度,值得临床推广应用。     

基于微信平台的系统化护理管理模式在美容整形患者中的应用效果

目的 观察基于微信平台的系统化护理管理模式在美容整形患者中的应用效果。方法 选取 2021年12月-2022年12月于西安交通大学口腔医院行美容整形的180例患者为研究对象,采用随机数字 表法分为对照组和观察组,每组90例。对照组采用常规护理模式,观察组采用基于微信平台的系统化 护理管理模式,比较两组康复知识掌握程度、满意度及心理状况。结果 观察组康复知识掌握程度优 于对照组（P＜0.05）;观察组对术后恢复效果及护理管理的满意度评分均高于对照组（P＜0.05）;观察 组SAS评分、SDS评分均低于对照组（P＜0.05）。结论 基于微信平台的系统化护理管理模式在美容整形患 者中的应用效果确切,可增加患者对康复知识掌握程度,提高其自护能力,同时可改善其不良情绪,有利 于提高患者的生活质量及护理满意度。     

微信平台用于强直性脊柱炎早期患者功能锻炼指导

目的探讨微信平台用于早期强直性脊柱炎患者功能锻炼指导的效果。方法将78例早期强直性脊柱炎患者按奇偶数分为对照组(39例)与观察组(39例)。对照组实施常规护理;观察组在此基础上借助微信平台建立微信群及远程视频,与患者进行互动并给予专业性督导,通过微信平台进行心理干预。分别于干预后3、6个月评价效果。结果干预后3个月枕墙距、晨僵时间、胸廓活动度、疼痛程度、睡眠质量及心理状况评分,观察组改善程度显著优于对照组(P0.05,P0.01);干预后6个月功能锻炼依从性观察组显著高于对照组(P0.01)。结论微信平台用于强直性脊柱炎早期患者功能锻炼指导,可有效提高锻炼效果,同时有利于改善睡眠质量及心理状况,从而提高患者生活质量。     

Indications for neurosurgical treatment of chronic pain

Summary Guidelines are presented for the neurosurgical treatment of chronic pain. In these guidelines a distinction is made between the pain of cancer and neurogenic pain. In cancer pain the survival time and the location of the lesion are the important guidelines. Possible procedures are: opioids via CSF route, lesions in nociceptive pathways and PV-PAG stimulation of the thalamus. In neurogenic pain, neurostimulation procedures, tailored to the location of the pain are procedures of first choice. There are however specific indications for other procedures depending on the aetiology of the pain. Causalgia and reflex sympathetic dystrophy: sympathetic blocade; Tic douloureux: radio-frequency lesion, glycerol, balloon inflation of the ganglion of Gasser, and microvascular decompression; Plexus avulsion: dorsal root entry zone lesion (D.R.E.Z.).There is a need for controlled prospective neurosurgical trials in which as a minimal rule an independent party should evaluate the results of the surgical procedure.Invited Lecture, presented at the European Congress of Neurosurgery, Moscow, June 23–29, 1991.     

Feasibility of virtual reality-delivered pain psychology therapy for cancer-related neuropathic pain: a pilot randomised controlled trial

Virtual reality-delivered psychological therapies have recently been investigated as non-pharmacological management for acute and chronic pain. However, no virtual reality pain therapy software existed that met the needs of cancer patients with neuropathic pain. We created a bespoke virtual reality-delivered pain therapy software programme to help cancer patients manage neuropathic pain incorporating guided visualisation and progressive muscle relaxation techniques, whilst minimising the risk of cybersickness in this vulnerable patient population. This randomised controlled pilot study evaluated the feasibility, acceptability, recruitment rates and risk of cybersickness of this pain therapy software programme. Clinical outcomes including opioid consumption, pain severity, pain interference and global quality of life scores were secondary aims. Of 87 eligible cancer patients with neuropathic pain, 39 were recruited (47%), allocated to either the intervention (20 patients, virtual reality pain therapy software programme) or control (19 patients, viewing virtual reality videos). Four patients withdrew before the 3-month follow-up (all in the control group). Pre-existing dizziness (Spearman ρ 0.37, p = 0.02) and pre-existing nausea (Spearman ρ 0.81, p < 0.001) were significantly associated with risk of cybersickness in both groups. Patients in the intervention group reported less cybersickness, as well as tolerated and completed all therapy sessions. At 1- and 3-month follow-up, there were trends in the intervention group towards reductions in: oral morphine equivalent daily dose opioid consumption (−8 mg and −4 mg; vs. control: 0 mg and +15 mg respectively); modified Brief Pain Inventory pain severity (−0.4, −0.8; vs. control +0.4, −0.3); and pain interference (−0.9, −1.8; vs. control −0.2, −0.3) scores. The global quality of life subscale from the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30 was not significantly changed between groups at 1 and 3 months (intervention: −5, −8; vs. control: +3, +4). This newly created virtual reality-delivered pain therapy software programme was shown to be feasible and acceptable to cancer patients with neuropathic pain. These results will aid the design of a definitive multicentre randomised controlled trial.     

居家癌痛患者镇痛治疗现状及影响因素分析

目的了解居家癌痛患者镇痛治疗现况并分析影响因素,为制定干预措施缓解或减轻居家癌痛患者疼痛程度提供依据。方法选择在某三甲医院镇痛门诊治疗的居家癌痛患者158例,采用自制癌痛信息调查表以电话随访方式进行6个月的跟踪随访,随访内容包括疼痛评分、疼痛性质、疼痛部位、用药情况、药物不良反应、门诊复诊等。结果居家癌痛患者疼痛控制程度总均分为5.93±1.62;不同性别、年龄、疼痛性质、疼痛部位、是否自行使用过镇痛药、药物不良反应类型及发生不良反应后应对方式的患者疼痛控制程度评分比较,差异有统计学意义（P〈0.05,P〈0.01）。结论居家癌痛患者镇痛效果不理想,疼痛未能得到良好的控制与多种因素相关。医务人员应深入社区、家庭,加强对癌痛规范化治疗的宣传,帮助患者居家期间规范用药,有效控制疼痛。     

乳腺癌术后疼痛及镇痛方法的研究进展

背景 乳腺癌为女性患者常见的一种恶性肿瘤,手术治疗是主要的治疗措施.乳腺癌术后疼痛具有独特的疾病特点,并且可以成为一种慢性疼痛长期影响患者的生活质量,一直是临床亟待解决的问题. 目的 阐述乳腺癌术后疼痛及镇痛方法的研究进展,为疼痛的预防和治疗提供参考. 内容 综述乳腺癌术后疼痛及其镇痛方法的研究现状. 趋向 进一步探讨乳腺癌术后疼痛综合征的治疗方法,以明确有效的防治措施.     

The future role of the anaesthesiologist in pain management

Background: Relieving pain during and after surgery and trauma has always been a basic duty of anaesthesiologists. With their skills and expertise in regional analgesia and pharmacological analgesia, anaesthesiologists have improved management of severe cancer pain. Will there be a place for anaesthesiologists in multidisciplinary pain clinics managing chronic non‐cancer pain patients in the future? Methods: This is a personal review of the development of pain management as a growing part of the responsibilities of anaesthesiologists during the past three decades and the importance of continued involvement of anaesthesiologists in this interesting and challenging aspect of clinical medicine. Results and conclusions: Optimal management of pain during and after surgery is a prerequisite for successful short‐ and long‐term rehabilitation after surgery. After surgery, reducing dynamic pain with prolonged optimal epidural analgesia and regional blocks facilitates mobilization and reduces chronic pain. The expertise of well‐trained anaesthesiologists in skilfully using regional analgesia and pharmacological pain relief continues to be in demand in palliative care. Some interventional techniques are useful in relieving chronic non‐cancer pain in selected patients. Well‐trained anaesthesiologist‐pain clinicians can perform interventional treatments safely. No doubt, anaesthesiologists will continue to have important roles in pain management in the future.     

Epidural and intrathecal analgesia for cancer pain

The three-step analgesic ladder approach developed by the World Health Organization works well in treating the vast majority (70–90%) of patients suffering from pain related to cancer. In those patients who do not get pain relief by this three-step approach, intraspinal agents can be a fourth step in managing pain of malignant origin. Although morphine is the only opioid approved by the US Food and Drug Administration for intraspinal use, many different opioid analgesics are used intraspinally, including hydromorphone, fentanyl, sufentanil, meperidine and methadone in the treatment of cancer pain. Many non-opioid agents have also been used intraspinally either alone or in combination with opioids in the treatment of intractable cancer pain. This chapter summarizes the clinical use of these agents with some practical points.