护理指导改善神经病理性疼痛患者药物依从性研究

目的探讨护理指导改善神经病理性疼痛患者服用阿片类药物的依从性。方法选择2010年3—9月在上海交通大学附属第六人民医院门诊疼痛科就诊的神经病理性疼痛患者90例,随机分为干预组和对照组各45例。干预组给予曲马多缓释片后进行4周护理指导,对照组给予曲马多缓释片后常规宣教。比较干预组和对照组给药1周、2周、3周及4周后疼痛变化、不良反应情况及患者对药物依从性程度。结果两组患者在给药1周、2周、3周及4周后疼痛情况较给药前均明显改善,第1周两组间疼痛比较差异无统计学意义(P>0.05);第2～4周时,对照组患者的疼痛高于干预组,两组比较差异有统计学意义(P<0.01)。两组患者在给药1周后均出现不良反应,差异无统计学意义(P>0.05),给药2～4周后对照组不良反应加重,与干预组比较差异有统计学意义(P<0.01)。给药1周时两组患者对镇痛药物的依从性高,差异无统计学意义(P>0.05),给药后2～4周,干预组对镇痛药物的依从性明显高于对照组(P<0.01)。结论护理指导可以减轻阿片类药物治疗神经病理性疼痛的不良反应,提高患者对镇痛药物的依从性,有效控制疼痛,提高患者的生活质量。

Nursing intervention can improve opioid compliance in patients with neuropathic pain

Objective To investigate the influence of nursing intervention on improvement in opioid compliance in patients with neuropathic pain. Methods A total of 90 patients with neuropathic pain for fist visit to Pain Management Center of our hospital from March to September 2010 were selected and randomly divided into the intervention group and control group （45 cases in each group）. After tramadol administration a four-week nursing intervention plan was implemented in the intervention group, while the control group only received conventional education. The pain scores, side effects of drug and patient compliance were evaluated every week. Resuits Compared to pretreament, pain scores decreased at each week after tramadol administration in the two groups, and there was no difference between them at week 1 （ P 〉 0.05 ）. Compared to those in the intervention group, the pain scores significantly increased in the control group at weeks 2 to 4 （P 〈 0.01 ）. The side effects of drug appeared after one week in both groups, without significant differences （P 〉 0.05 ）. At weeks 2 to 4 the side effects aggravated in the control group, with significant differences between the two groups （P 〈0.01）. The patient compliance to analgesic medication was not significantly different between the two groups at week 1 （P 〉 0.05）, but at weeks 2 to 4 the intervention group showed better compliance than the control group （ P 〈 0.01 ）. Conclusion Nursing intervention can reduce the side effects of opioid therapy for neuropathic pain, improve the patient compliance, relieve pain, and improve the patient quality of life.