| Objective: To investigate the factors that influence the pain severity of patients with diabetic retinopathy after traditional pan-retinal laser photocoagulation using 532 nm argon ion laser,and to conduct preoperative intervention to alleviate patients’ intraoperative pain experience.Methods: A prospective single-center study.The subjects of the study were severe NPDR and PDR patients receiving laser treatment at Shenyang He Eye specialists Hospital.The treatment was completed by the same experienced retinal doctor,and a questionnaire survey was used by the same doctor before treatment to investigate the basic information and psychological state of the patient.Use the Simple Coping Scale and the SAS Anxiety Self-Rating Scale to evaluate the psychological state,collect the relevant parameters of laser treatment,and ask the patient immediately(within 1 minute)after completing the retinal laser photocoagulation about the intraoperative pain perception and score.Pain scoring uses two forms: oral response and score sheet.Use the 2010 version of Excel to create tables to enter the data,the statistical analysis software is SPSS21.0.Statistical methods: For the correlation analysis between binary categorical variables and unordered multi-categorical variables and continuous data,two independent samples T test and parameter analysis are used;for the correlation analysis between ordered categorical variables and continuous variables,Kendall’s tau-b method is used,and for the correlation analysis between two continuous variables,Spearman rank correlation method is used.The establishment of regression equation adopts multifactor linear regression analyzing method.Investigate factors related to the postoperative pain score,so as to determine the specific group of people available for applying preoperative intervention and reduce postoperative pain.Results: This study investigated a total of 113 patients,and finally received a complete result of 89 cases(89 eyes),including 41 male patients and 48 female patients.The treatment range of traditional pan-retinal laser photocoagulation is divided into four quadrants: upper,lower,nasal,and temporal.The proportions of the collected patients in the treatment quadrants are 33 cases(37.08%)and 9 cases(10.11%),respectively.19 cases(21.35%),28 cases(31.46%),the average number of laser shots was 347;the distribution of pain levels felt by patients after traditional pan-retinal laser photocoagulation: no pain in 8 cases(9.00%),34 cases(38.20%)of moderate pain,26 cases(29.21%)of moderate pain,and 21 cases(23.60%)of severe pain;the average pain score after traditional pan-retinal laser photocoagulation was 4.56±2.776 points,and patients with 0 points in 7 cases(7.87%),30 cases(33.71%)were scored 1-3,30 cases(33.71%)were scored 4-7,and 22 cases(24.72%)scored 8-10.5 cases(5.62%) had nausea and vomiting after traditional pan-retinal laser photocoagulation.The results of multiple linear regression analysis showed that the pain score of women after laser surgery was 1.258 points higher than men(β=1.258,P=0.04);Compared with patients without medical insurance,the pain score of patients with medical insurance was 1.685 points higher(β=-1.685,P=0.019).Conclusion: When 532 nm argon ion laser PRP is used to treat NPDR and PDR,women and those with medical insurance are related to the pain score after laser surgery.The above factors can be used as a reference for predicting the degree of postoperative pain.The corresponding group of patients should be psychologically treated before surgery.Intensified intervention,if necessary,can increase the degree of anesthesia.Patients can change the anesthesia method to reduce the degree of pain during and after the operation,so as to improve the patient’s treatment compliance and obtain better treatment results. |
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