مقایسه اثر نوار حاوی ژل خنک کننده با بسته یخ برشدت درد پرینه بعد از اپی زیاتومی

نوع مقاله : اصیل پژوهشی

نویسندگان

1 مربی و عضو هیئت علمی دانشکده پرستاری و مامایی مشهد

2 کارشناسی ارشد مامایی

3 رزیدنت زنان و زایمان

4 استاد یار گروه پزشکی اجتماعی دانشگاه علوم پزشکی مشهد

چکیده

مقدمه: درد پرینه ناشی از اپی زیاتومی، همواره مشکلی استرس زا برای زنان نخست زا بوده و اثر منفی
بر عملکرد و اولین تجربه مادر شدن را دارد از آنجا که اکثر زنان نخست زا اپی زیاتومی می شوند، ایـن
پژوهش با هدف مقایسه اثر نوار حاوی ژل خنک کننـده بـا بـسته یـخ بـر شـدت درد پرینـه بعـد از اپـی
زیاتومی در زنان نخست زای زایمان کرده در بیمارستان حضرت ام البنین (س) مشهد از مهر تـا بهمـن
ماه 1384 انجام گردید.
روش کـار: در ایـن کـار آزمـایی بـالینی 121 زن نخـست زا بـا معیارهـای ورود بـه مطالعـه، بـه روش
تخصیص تصادفی در دو گروه سرما درمانی (نوار حاوی ژل خنک کننده، بسته یخ) و گروه کنترل قـرار
گرفتند. واحدهای پژوهش طی 4 ساعت اول بعد از اپی زیاتومی توسط پژوهشگر و پس از آن بر اسـاس
تقاضای خود، درمان را دریافت کردند. ارزیابی شدت درد با مقیاس عـددی درجـه ای و بهبـود زخـم بـا
مقیاس ریدا طی 4 ساعت اول و روزهای اول، دوم، پنجم و دهم و رضایت درمان در روز دهـم صـورت
گرفت. اطلاعات توسط آزمونهای پارامتری و غیر پارامتری مورد تجریه و تحلیل آماری قرار گرفت.
نتایج: سه گروه از نظر شدت درد پرینه طی 4 سـاعت اول (P=0/003) و روز دهـم (P= 0/044) بعـد از
اپی زیاتومی و کاهش نیاز به دارو (استامینو فن) به نفع گروه نوار حـاوی ژل تفـاوت آمـاری معنـی دار
داشـتند (p<0/001). دو گـروه سـرما درمـانی از نظـر میـانگین نمـره ر ضـایت از ضـد درد موضـعی
(p=0/001) و بهبود زخم نیز به نفع گروه نوار حاوی ژل تفاوت آماری معنی دار داشتند (p<0/001).
نتیجه گیری: استفاده از نوار حاوی ژل خنک کننده در کاهش شدت درد پرینه و کاهش نیاز به دارو
مؤثر است. لذا به عنوان روشی ایمن و بدون عارضه و قابل استفاده در بیمارستان و منزل پیشنهاد
می شود

کلیدواژه‌ها


عنوان مقاله [English]

Comparing the Effect of Colling Gel Pads and Ice Pack, after Episiotomy, on the Intensity od Perinal Pain

نویسندگان [English]

  • Zahra Abedian 1
  • Shahin Dokht Navabi Rigi 2
  • Salmeh Dadgar 3
  • Habib Esmaili 4
1
2
3
4
چکیده [English]

Introduction: There are still considerable morbidities associated with childbirth, despite of the fall in material mortality in the last country. Episiotomy is performed for most of primiparous women and the pain related to this treatment is typically treated with oral analgesic medications. Application of cooling devices is a new approach in pain reliefe.
 
This research was carried out, from October 2005 to February 2006, to determine the effect of two cooling devices (gel pad and ice pack) on the intensity of perineal pain and to compare its effects with no localised treatment regime (control) in women who gave birth at Hazrat Ommolbanin University Maternity Hospital in Mashhad –Iran.
 
Material and Methods: In this randomized controlled trial, 121women, with the necessary criteria were sampled and randomely allocated in the two groups of cold therapy (ice pack, cooling gel pad) and the control group (acetaminophen). At hospital, during a period of 4 hours after episiotomy, and then on demand of individuals, to reclnce the intensity of perineal pain at home, subjects received analgesia. During the first 4 hours and on the days 1, 2, 5, 10 after episotomy, perineal pain intensity was evaluated, using Numeric Rating Scale (NRS). Evaluation of women satisfaction from analgesia accomplished on the day 10. Data analyzed by statistics parametric and nonparametric methods, using the SPSS software.
 
Results: There was a statistically significant difference in the intensity of perineal pain in three groups at 4 hours (p=0.003) and on the day 10 (p= 0.044), after episiotomy, which was in favour of the maternity gel pad group. A considerable variation, observed in the reduced necessity for medication and satisfactory treatment, among three groups.
 
Conclusion: Maternity gel pads are effective in reducing the perineal pain intensity, and the need for medication. Therefore, cooling gel pads are suggested as a safe and adequate method of perineal pain relief, which is applicable both at hospital and home.

کلیدواژه‌ها [English]

  • Episiotomy
  • Perineal pain
  • Primiparous
  • Cooling gel pad
  • Ice pack
  • Pain reliefe
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