目的：探讨妇科癌症患者疼痛的护理措施。方法：60例妇科癌症患者随机分为常规护理、特殊护理，观察疼痛治疗效果。结果：特殊护理患者疼痛缓解明显。结论：护理干预能改善患者疼痛。
ObjectiveTo investigate the clinical effect of three-port Da Vinci robot-assisted radical resection of lung cancer. MethodsThe clinical data of patients who underwent Da Vinci robot-assisted radical resection of lung cancer in the Second Department of Thoracic Surgery, the First Affiliated Hospital of Xiamen University from April 2021 to March 2022 were retrospectively analyzed. According to the number of surgical ports, they were divided into two groups: a three-port group (three-port Da Vinci robot-assisted radical resection of lung cancer), and a four-port group (traditional Da Vinci robot-assisted radical resection of lung cancer). The operation time, intraoperative bleeding, lymphadenectomy, total thoracic drainage, extubation time, postoperative complications and postoperative pain of the two groups were compared and analyzed. ResultsA total of 58 patients were included, including 19 males and 39 females, aged 31-79 years. There were 21 patients in the three-port group, and 37 patients in the four-port group. The visual analogue scores on the first and third day after the operation were 4.33±1.20 points and 2.24±0.77 points in the three-port group, and 5.11±1.22 points and 2.78±1.06 points in the four-port group, and there were statistical differences between the two groups (P<0.05). There was no significant difference between the two groups in terms of operation time, intraoperative bleeding, lymph node dissection, postoperative thoracic drainage, time of thoracic tube insertion or postoperative complications (P>0.05). ConclusionThree-port Da Vinci robot-assisted radical resection of lung cancer can reduce the postoperative pain without increasing the operation difficulty and complications, and can be widely used in the clinical practice.
Objective To evaluate the efficacy and safety of Chinese herb compared with an analgesic drug in the treatment of cancer pain. Methods We electronically searched CBM (1990 to 2008), CNKI (1990 to 2008), VIP (1990 to 2008), The Cochrane Library (Issue 3, 2008), and MEDLINE (1990 to 2008). Relevant journals and conference proceedings were also handsearched. The quality of the included trials was assessed according to the criteria recommended by the Cochrane Handbook for systematic reviews of interventions and meta-analyses were performed for homogeneous studies using the Cochrane collaboration’s review manager 4.2.2 software. Results Five randomized controlled trails (RCTs), all published in Chinese, involving 590 participants, were included. The quality of all RCTs was graded C (low). Meta-analyses were not performed due to heterogeneity. Instead, descriptive analyses were conducted. The results showed that as for the total effective rate in pain-relieving, Zhentongsan (RR=1.11, 95%CI 1.00 to 1.24, P=0.05) and Xiaozhengzhitong paste (RR=1.35, 95%CI 1.02 to 1.78, P=0.04) were more effective than Indometacin, with significant differences. There were no significant differences between Duyiwei capsule and Indometacin, and so were between Huajianbadumo as well as Shebingzhitong paste and Tramado. In terms of early potency, there were significant differences between Zhentongsan (SMD= –?9.87, 95%CI –10.84 to –8.89, Plt;0.000 01) as well as Xiaozhengzhitong paste (SMD= –8.74, 95%CI –10.164 to –7.32, Plt;0.000?01) and Indometacin, and so were between Shebingzhitong paste and Tramadol (SMD= –2.24, 95%CI –3.00 to –1.49, Plt;0.000?01). There were no significant differences between Huajianbadumo and Tramodo. With regard to the durative effect on pain-relieving, there were significant differences between Xiaozhengzhitong paste and Indometacin (WMD=4.78, 95%CI 2.99 to 6.57, Plt;0.00001), but not between Shebingzhitong paste and Tramadol. Conclusion Because of low quality of the existing studies, the current evidence is insufficient to define the efficacy and safety of compound Chinese herb, and further large-scale and high-quality RCTs are needed.
Objective To analyze the causes of pain after total knee arthroplasty (TKA), and to review its diagnosis and treatment methods. Methods Domestic and abroad l iterature concerning pain after TKA was extensively reviewed and thoroughly analyzed. Results Pain after TKA was divided into intra-articular and extra-articular factors, systematic assessment, appropriate imaging, and laboratory tests were useful to confirm the diagnosis; targeted surgery could effectively rel ieve the pain. Conclusion The causes of pain after TKA are complex and diverse, the first step is to exclude intraarticular infection, for patients having a clear cause the appropriate surgery is effective. Otherwise revision should be carried outcautiously under condition of unexplained pain and conservative treatment can rel ieve pain to some degree.
ObjectiveTo construct a nomogram prediction model for pain crisis occurrence based on clinical data of patients with advanced non-small cell lung cancer (NSCLC), with the aim of providing a scientific basis for clinical decision-making.MethodsA total of patients with advanced non-small cell lung cancer (NSCLC) admitted to our hospital from January 2022 to January 2024 were selected as the study subjects. Demographic data, disease information, pain severity (assessed using the Numerical Rating Scale, NRS), psychological status (anxiety and depression assessed using the Self-Rating Anxiety Scale, SAS, and the Self-Rating Depression Scale, SDS), and social support (assessed using the Perceived Social Support Scale, PSSS) were collected. Univariate and multivariate Logistic regression analyses were performed to identify independent factors influencing pain crisis. The R software was used to visualize the nomogram, and the Receiver Operating Characteristic (ROC) curve, calibration curve, and Hosmer-Lemeshow test were employed to evaluate the discrimination and calibration of the model.ResultsA total of 500 questionnaires were distributed, and 448 qualified questionnaires were collected, with a qualification rate of 89.6%. The patients were divided into a modeling group (n=314) and a validation group (n=134). Univariate analysis showed significant differences between the pain crisis group and the pain-free group in terms of gender, age, education level, PSSS score, bone metastases, pleural metastases, depression and anxiety levels, and antitumor efficacy (P<0.05). Multivariate Logistic regression analysis showed that bone metastasis, PSSS score, age, depression, and anxiety levels were independent factors influencing pain crisis in patients with advanced NSCLC. Based on the results of the multivariate Logistic regression analysis, a nomogram prediction model for pain crisis occurrence in patients with advanced NSCLC was constructed. The Area Under the Curve (AUC) of the ROC curve in the modeling and validation groups was 0.948 and 0.921, respectively, indicating high discrimination of the model. The calibration curve and Hosmer-Lemeshow test results showed good consistency of the model.ConclusionThis study successfully constructed and validated a nomogram prediction model based on independent factors such as bone metastasis, social support (PSSS score), age, depression, and anxiety levels. This model can objectively and quantitatively predict the risk of pain crisis occurrence in patients with advanced NSCLC, providing a scientific basis for clinical decision-making. It helps identify high-risk patients with pain crisis in advance and optimize pain management strategies, thereby improving patient prognosis and quality of life.
Objective To analyze the clinical effect of individualized pain nursing intervention on the pain relieving after ambulatory laparoscopic cholecystectomy (LC) . Methods From March to June 2017, a total of 180 ambulatory LC patients were selected and randomly asigned into the control group and the intervention group with 90 cases in each group. Parecoxib sodium (40 mg) was preoperatively administrated half an hour before the surgery to the patients in both of the two groups. The patients in the control group were treated with routine nursing intervention, while the ones in the intervention group were given individualized pain nursing interventions, including regular pain assessment, preoperative pain health guidance, enhanced education for pain related knowledge, and following the nursing theory of enhanced recovery after surgery. Visual Analogue Scale (VAS) was used to measure the degree of postoperative pain, and the data of dormant pain were collected. Results There was no significant difference between the two groups in VAS one hour after the operation (P>0.05); the VAS scores 2, 6 and 12 hours after the operation gradually decreased in the two groups (P<0.05), and the scores of patients in the intervention group were much lower than those in the control group (P<0.05). The time of pain relieving in the intervention group and the control group was (3.25±1.72) and (5.39±2.06) hours, respectively, and the difference was statistically significant (P<0.05). The incidence of dormant pain in the intervention group (12.2%) was lower than that in the control group (33.3%), and the difference was statistically significant (P<0.05). Conclusion Individualized pain nursing interventions can effectively alleviate the postoperative pain and improve the quality of sleep in ambulatory LC patients.
Pain education based on biomedical models is currently a common approach to patient pain management. However, due to its inability to accurately explain pain, patients may develop incorrect beliefs and understandings about pain, leading to anxiety and fear of movement. Pain neuroscience education is based on a biological psychological social educational model, aiming to redefine the concept of pain. It has a positive effect on pain, catastrophizing, anxiety, and fear of movement, and is a reliable new method for pain rehabilitation therapy and management. This article provides a review of the concept, implementation principles, implementation methods, dosage factors, combination therapy, and clinical application of pain neuroscience education, in order to provide ideas for the rehabilitation therapy of pain.
ObjectiveTo systematically evaluate the measurement properties of observational pain assessment scales for pediatric patients after surgery. MethodsThe PubMed, Embase, CINAHL, PsycArticles, and SinoMed databases were electronically searched to collect studies related to the objects from inception to April 13, 2024. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. And the quality of measurement properties was rated using updated criteria for good measurement properties to determine recommendation levels. ResultsA total of 26 studies were finally included involving 12 observational pain assessment scales for pediatric patients after surgery. None reported measurement error or cross-cultural validity. The overall content validity of all 12 scales was evaluated by reviewers, with measurement properties rated as sufficient or inconsistent. For internal consistency, due to insufficient or uncertain content validity, the evidence quality was low. Eight scales calculated internal consistency, among which CHEOPS, CHIPPS, COMFORT, FLACC, and NCCPC-PV scales had sufficient measurement properties with evidence quality of low or above, receiving Grade A recommendations. ConclusionCompared with other scales, CHEOPS, CHIPPS, COMFORT, FLACC, and NCCPC-PV scales demonstrated good measurement property evaluation with acceptable evidence quality and can be recommended for use. Other scales still require further improvement in measurement property validation.