경피적 전기신경자극이 폐암환자의 폐엽절제술 후 통증, 폐기능 및 동맥혈가스분압에 미치는 효과

Other Titles
The Effect of Transcutaneous Electrical Nerve Stimulation on Pain, Pulmonary Function Test and The Analysis of Arterial Blood Gas with Post-lobectomy Patient with Lung Cancer
Authors
전현례
Issue Date
2009-06
Awarded Date
2009
Abstract
This study is designed for a pure experimental purpose to evaluate the effect of transcutaneous electrical nerve stimulation on pain, pulmonary function and arterial blood gas of post-lobectomy patients with lung cancer. The study was performed in cardiac surgery intensive care unit from K University D hospital in Daegu. Data collection was done from February 4, 2008 to February 7, 2009. Subjects were assigned randomly to experimental and control groups by tossing a coin on the day of surgery. The experimental group measured the pain and arterial blood right after surgery, and they measured the pain, arterial blood after applying 100Hz frequency and 40mA output for 20 minutes. The same procedure was repeated 2hrs, 4hrs, 6hrs, 8hrs after surgery. The adhesion of TENS was same with the experimental group. But they measured the pain and arterial blood in the same way after applying no electricity sham TENS for 20 minutes. Pulmonic functions were measured before and after applying TENS 2hrs, 4hrs, 6hrs, 8hrs after surgery. The pain intensity was measured by using numeric rating scale and the number of times of receiving painkillers. pulmonary function was measured by MicroLab PO Box 6, arterial blood gas by Rapid lab 850. The subjects were assigned to 20 of Experimental group and Control group. The data were analyzed using. t-test, ANOVA, ANCOVA, with SPSS for windows (version 15.0) The results of this study were as follows: 1. The pain scale of the experimental group which applied TENS revealed that there were more significant reductions than the control group which applied sham TENS at 2 hours, 4 hours, 6hrs, and 8hours. (after surgery 2 hours t=2.53, p=.016, after surgery 4 hours t=3.60, p=.001, after surgery 6 hours t=2.73, p=.010, after surgery 8 hours t=3.61, p=.001) 2. There was no significant difference with the number of times of receiving painkillers between the experimental and control group. 3. The effect of TENS to pulmonary function is as follows : there was notable difference from the first to last between Experimental group VC 2 hours after surgery(t=5.68, p=.024). There was no statistical difference among 2 hours, 6 hours, 8 hours after surgery. And there was no significant difference between FVC and FEV1. 4. The effect of TENS to arterial blood gas is as follows : PaO in arterial blood of the experimental group 4 hrs after surgery became higher than the control group(F=5.83, p=.021) and there was no remarkable difference in 2 hours, 6 hours, 8 hours after surgery. PaCO in arterial blood of experimental group and control group was almost the same. The findings of the study indicated that the TENS was effective on easing the pain of the patients after lobectomy. Therefore, TENS would be recommended as an effective and non-pharmacologic nursing intervention for relieving pain with patients after lobectomy.
본 연구는 경피적 전기신경자극이 폐암환자의 개흉술을 통한 폐엽절제술후 통증, 페기능 및 동맥혈가스분압에 미치는 효과를 규명하기 위해 시행된 순수 실험연구이다. 2008년 2월 4일부터 2009년 2월 7일까지 대구시 K 대학교 D병원에서 폐암으로 폐엽절제술을 받은 환자 40명을 대상으로 하였으며 모든 환자로부터 서면동의를 얻어 연구를 진행하였다. 대상자는 수술 당일 동전 던지기로 실험군과 대조군을 무작위 할당하였다. 실험군은 수술 후 중환자실에 도착 후 통증과 동맥혈가스분압을 측정하고 빈도 100Hz, 출력 40mA의 TENS를 20분간 적용한 후에 사후 통증, 동맥혈가스분압을 측정하였다. 동일한 방법으로 수술 후 2시간, 4시간, 6시간, 8시간에 통증, 동맥혈가스분압을 측정하였다. 대조군은 전기가 들어가지 않는 Sham TENS 20분 간 적용한 후에 실험군과 동일한 방법으로 통증, 동맥혈가스분압을 측정하였다. 폐기능은 수술 후 2시간, 4시간, 6시간, 8시간에 측정하였다. 통증은 숫자평정척도와 진통제사용 횟수로 측정하였으며, 폐기능은 Spirometer (MicroLab PO box 6), 동맥혈가스분압은 Rapid lab 850.을 이용하여 측정하였다. 수집된 자료는 SPSS 프로그램(version 15.0)을 이용하여 t-test, ANOVA, ANCOVA로 분석하였다. 본 연구 결과는 다음과 같다. 1. TENS를 적용한 실험군의 통증점수는 수술 후 2시간, 수술 후 4시간, 수술 후 6시간, 수술 후 8시간에 sham TENS를 적용한 대조군보다 유의하게 많이 감소되었다(수술 후 2시간 t=2.53, p=.016, 수술 후 4시간 t=3.60, p=.001, 수술 후 6시간 t=2.73, p=.010, 수술 후 8시간 t=3.61, p=.001). 2. 진통제 사용 횟수는 실험군과 대조군간 유의한 차이를 보이지 않았다. 3. TENS가 폐기능에 미친 효과를 보면, 수술 후 2시간째 실험군 VC가 대조군보다 유의하게 전후 차이가 많이 났고(t=5.68, p=.024), 수술 후 4시간, 6시간, 8시간에는 통계적으로 유의한 차이가 없었다. FVC과 FEV1은 양군 간에 유의한 차이가 없었다. 4. TENS가 동맥혈가스분압에 미친 효과를 보면, 수술 후 4시간째 실험군의 동맥혈내 PaO2가 대조군보다 유의하게 높아졌고(F=5.83, p=.021), 수술 후 2시간, 6시간, 8시간에는 통계적으로 유의한 차이가 없었다. 동맥혈내 PaCO2는 실험군과 대조군간에 유의한 차이를 보이지 않았다. 이상의 결과들을 종합해 볼 때, 경피적 전기신경자극은 폐엽절제술 후 환자의 통증완화에 효과가 있는 비약물적이고 효과적인 중재라고 할 수 있다. 그러므로 이를 임상에서 활용하기를 권장하는 바이다.
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/11064
Appears in Collections:
3. Thesis (학위논문) > 2. College of Nursing (간호대학) > 석사
Full Text
http://dcollection.kmu.ac.kr/jsp/common/DcLoOrgPer.jsp?sItemId=000000008133
File in this Item
There are no files associated with this item.
Export
RIS (EndNote)
XLS (Excel)
XML


qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

BROWSE