| Objective: Postherpetic neuralgia is a refractory neuropathic pain, which seriously disturb patients’ work and their life and so far, special methods and drugs are lack to completely relieve the pain of patients. The purpose of this study is, according to the characteristics of diseases of postherpetic neuralgia, to design pain management path and put it into clinical application, to investigate the effect of pain management path for postherpetic neuralgia on patients, and to evaluate the value of the clinical application, in order to find an effective pain management standards, so as to reduce the suffering of patients and improve their quality of life.Methods: Ninty patients with herpes zoster neuralgia who were treated in our hospital pain department from December, 2013 to August, 2014 were selected(in line with the pain of postherpetic neuralgia diagnosis standard in the first version of “PAIN” on 2012, diagnosis of postherpetic neuralgia), these patients’ ages were varies from 50 to 85, gender was not limited and the pain was in the chest and abdomen of patients. Random number table method was used to divide the patients into two groups: the control group and the experimental group with 45 cases in each group. After admission, the two groups were given the same drug treatment, but the control group adopts the model of conventional nursing care, the experimental group adopts the pain management path. Adopting numerical rating scale, NRS, Wisconsin Brief Pain Inventory and Houston Pain Outcome Instrument, HPOI to evaluate respectively the degree of pain of patients before treatment and 5 days and 10 days after the treatment, to evaluate the effect of pain on sleep and the overall satisfaction of patients on pain control, and to evaluate the incidence of common adverse reactions of the two groups of patients with constipation and to compare the hospitalization days and hospitalization expenses of the two groups of patients.Results:1 The experimental group and the control group were compared in gender, age, course of disease, once medication, P > 0.05, the data was balance between the two groups, and there was no significant difference, so the data is comparable; the rate of once medication was 100%. In the age, the average age of the experimental group was(68.22 + 11.74), the control group was(66.21 ±9.65), the two ages had no significant difference between the two groups(P=0.254); the sex ratio of the two groups are of no significant difference(P=0.833).2 The comparison difference of the two groups of patients with NRS scores have no statistical significance before treatment(P=0.850); after a 5-day treatment, the NRS score for the experimental group was(3.07±1.34), lower than that of the control group scored(4.29±1.74), the difference was statistically significant(P=0.019). After a 10-day treatment, the NRS score for the experimental group was(1.09±0.90), lower than that of the control group scored(2.27±1.32), the difference was statistically significant(P=0.010).3 The score of the overall satisfaction of pain control after treatment of 5 days in the experimental group is(5.51 ± 1.74), higher than that of the control group, which is(4.49±1.60), the difference was statistically significant(P=0.005). After a 10-days treatment, in the experimental group, the satisfaction score for pain control was(7.96±1.30), which is higher than that of the control group(6.96±1.51), the difference was statistically significant(P=0.001).4 The comparison difference of the interference degree which the pain on patients’ sleep of the two groups before treatment had no significant difference(P=0.65). After a 5-day treatment, the score of the experimental group was(3.36 ±1.28), lower than that of the control group, which was(4.27±1.60), the difference was statistically significant(P=0.004). After a 10-day treatment, the score of the experimental group was(1.20±0.79), lower than the control group scored(2.42±0.94), the difference was statistically significant(P=0.000).5 After a 5-day treatment, in the experimental group, there were 7 cases of constipation out of 45 cases, while of all the 45 patients in the control group, there were 15 cases with constipation, with no significant difference between these two groups(P=0.085). After a 10-day treatment, in the experimental group, there were 12 cases of constipation out of 45 cases, while of all the 45 patients in the control group, there were 24 cases of constipation, the difference of the two groups was statistically significant(P=0.002).6 On average, the days of hospitalization of the control group was 15.76±3.54 days, the experimental group was 13.71±3.05 days, the difference was statistically significant(P = 0.004).7 The average hospitalization cost of the control group was 13972.24±3726.66 yuan, the experimental group was 11798.38±3312.33 yuan, the difference was statistically significant(P = 0.004).Conclusions:The application of the pain management path for pain ma nagement in patients with postherpetic neuralgia, can relieve the pain of patients, improve patient’s sleep quality, improve the overall satisfaction of pain control of patients. The length of hospital stay, the hospitalization costs and the occurrence of constipation can also be reduced. |
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