经皮肾镜取石术后患者疼痛状况调查［摘要］目的：调查经皮肾镜取石术后患者的疼痛状况，为术后进行有效疼痛管理提供依据。方法：采用视觉模拟标尺法(VAS)、疼痛及麻醉性镇痛药信念量表及自行设计的患者一般情况调查表对126例经皮肾镜取石术后患者进行调查，记录患者术后四个阶段内疼痛状况。结果：患者整体疼痛信念平均得分(2.90±0.26)分，以“麻醉性止痛药只应该被使用在疼痛剧烈时”和"麻醉性止痛药会引起许多副作用”两项平均得分最高，分别为(3.14±0.38)、(2.96±0.24)分；不同文化程度患者疼痛信念总分存在差异(F=4.45,P=0.02)o患者开始疼痛时间为术后(2.98±1,16)h,术后第一阶段疼痛程度最高，得分为(4.26±1.46)分，最严重时疼痛得分＞4分者85例(67.46%),疼痛最严重时间为术后(4.81±2.22)h,主要为手术部位钝痛，该阶段47.62%的患者使用镇痛剂，开始使用镇痛剂的时间为术后(6.51±2.63)h；第二阶段至第四阶段疼痛评分依次为(2.39土1.21)、(2.08±1.02)、(1.86±0.32)分,疼痛依次为牵拉引流管造成的疼痛、拔除肾引流管造成的疼痛、患侧腰部疼痛。术后四个阶段疼痛程度得分差异有统计学意义(F=3.57,P=0.04)o结论：经皮肾镜患者术后疼痛信念趋于负向，术后疼痛问题不容忽视，术后疼痛管理有待改善，应针对患者疼痛特点，实施有效疼痛管理。［关键词］疼痛；经皮肾镜取石术；数据收集［］R699.2；R473.6［文献标识码］C［］1673-7210(2011)11(b)-146-03Investig且tiononthepost-operativepainamongpa-tientswithPCNLWANGAisongl,CHENGNianzhen21.DepartmentofUrology,HernanTraditionalChi-neseMedicineHospital,Zhengzhou,450002,China；2.Departmento-fUrology,theAffiliatedXiangyaHospitalofSouthernMiddleUniver-sity,Changsha410008,China［Abstract］Objective：Toinvestigatethepost-opera-tivepainstatusinpatientsundergoingPCNL,inordertoprovidearef-erenceforeffectivepost-operativepainmanagementforpa-tientswithPCNL・Methods：Across-sectionstudywasconducte-din126patientswhounderwentPCNLwiththeVAS,PainandOpioidsAnal-gesicsBeliefsscaleandself-designedquestionnaire・ResuIts：ThemeanscoresofpainbeliefsofthepatientsundergoingPCNLwas(2.90±0.26),andtheitemswithhighestscoresof(3.14±0・38)and(2.96±0.24)were“opioidsanalgesicsshouldbeusedonlywheninsevere-pain"and“opioidsanalgesicsmaycausemanysideeffects"；andthereweresignificantdifferencesinpainbeliefsamongpa-tientswithdifferenteducationalbackgrounds(F二4.45,P二0.02).Thepainoccurredat(2.98+1.16)hoursafteroperation；anda-mongthefoursectionsthescoreofpaininthefirstsectionwasthe-highest[(4.26±1.46)scores]；therewere85patients(67・5%)ex-periencedthemostseverepainscoredmorethan4duringthefirstsec-tion；themostseverepainoccurredat(4.81+2.22)hoursafteropera-tioninthefirstsectionandthedullpaininsurgicalsitewasmostpop-ular.Inthefirstsection47.62%ofpatientsusedanalgesic-sandtheanalgesicswereusedat(6.51+2.63)hoursafteropera-tion.Thepainscoresinthesecond,thethirdandthefourthsection-were(2.39+1.21),(2.08+1.02),(1.86+0.32)respectively,andthep-aincausedbystretchingthedrainagetube,thepaincausedbyremov-ingthedrainagetubeandthepainintheaffectedlumbagowerepopular-duringthosesections・Therewasasignificantdifferenceinthep-ainscoresamongfourpost—operativesection(F=3.57,P二0.04).Conclusion：TheoverallpainbeliefsofpatientswithPCN-Larenegative,andthepost-operativepainisserioussymptomamong-patientswithPCNL.Thepainmanagementshouldbeimprovedandeffec-tivemeasuresshouldbetakenaccordingtothecharacteristicofthep-ain.［Keywords］Pain；PCNL；Datacollection经皮肾镜取石术（PCNL）是目前用于治疗肾脏结石尤其是大于2cm结石的主要手段。与传统开放手术相比，经皮肾镜取石术创伤小、术后住院时间短...