摘要
目的:构建神经外科无痛病房多学科疼痛管理模式,探讨其对开颅术后患者疼痛管理效果。方法:组建由神经外科医生、护士及疼痛科医生组成的多学科疼痛管理小组,将超前镇痛、多模式镇痛和个体化镇痛策略相结合,构建神经外科无痛病房多学科疼痛管理模式。选取医院收治的1056例开颅手术患者,依据疼痛管理模式的不同将其分为观察组与对照组,每组528例;观察组采用无痛病房多学科疼痛管理模式;对照组采用常规无特殊疼痛干预模式。对比两组患者术后4 d内的数字量表(NRS)疼痛评分、中重度疼痛比例、术后舒芬太尼使用量、镇痛满意度及生活质量。结果:观察组术后4 d的疼痛评分低于对照组,差异有统计学意义(F=1227,P<0.001),中重度疼痛比例低于对照组,差异有统计学意义(x^2=214.6,P<0.001);观察组术后总舒芬太尼用量低于对照组,差异有统计学意义(t=48.5,P<0.001),患者对镇痛效果满意度高于对照组,差异有统计学意义(x^2=61.3,P<0.001);观察组生活质量的总体问题、生理领域和心理领域得分高于对照组,差异有统计学意义(Z=-17.7,Z=-23.0,Z=-22.7;P<0.001)。结论:神经外科无痛病房多学科疼痛管理模式能最大程度地缓解患者术后疼痛,提升患者镇痛满意度和生活质量。
Objective:To construct multidisciplinary pain management mode of neurosurgical analgesia ward and explore the effect of pain management of this mode for postoperative patient underwent craniotomy.Methods:A multidisciplinary pain management team was composed by neurosurgical doctors,nurses and doctors of pain department.A series of strategies included preemptive analgesia,multi-modal analgesia and individualized analgesia were combined to construct multidisciplinary pain management mode of neurosurgical analgesia ward.A total of 1,056 patients who underwent craniotomy and admitted to hospital were selected as the research objects and they were divided into observation group and control group according to different pain management mode,with 528 cases in each group.The observation group adopted multidisciplinary pain management mode of neurosurgical analgesia ward and the control group adopted routine pain interference mode without specialty.The differences of the scores of numerical rating scale(NRS),the ratio of middle-severe pain,the usage amount of Sufentanil post operation,the satisfaction of analgesia and quality of life within 4 days post operation between two groups were significant.Results:The pain score within 4 days post operation of observation group was significantly lower than that of control group(F=1227,P<0.001),and the radio of middle-severe pain of observation group was also significantly lower than that of control group(x^2=214.6,P<0.001).The total of Sufentanil consumption of patients post operation of observation group was significantly lower than that of control group(t=48.5,P<0.001).And the degree of satisfaction on analgesic effect of observation group was significantly higher than that of control group(x^2=61.3,P<0.001).The scores of two general problems,physiological field and psychological field of life of quality of observation group were significantly higher than those of control group(Z=-17.7,Z=-23.0,Z=-22.7,P<0.05).Conclusion:The multidisciplinary pain management mode in neurosurgical analgesia ward can relieve the postoperative pain of patients to the greatest extent,and can improve the degree of satisfaction of analgesia and the quality of life of patients.
作者
肖峰
任美华
任浩
罗芳
XIAO Feng;REN Mei-hua;REN Hao(Office of Physician-Patient Relations,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)
出处
《中国医学装备》
2020年第10期150-154,共5页
China Medical Equipment
关键词
神经外科
无痛病房
多学科疼痛管理
镇痛
满意度
Neurosurgery
Analgesia ward
Multidisciplinary pain management
Analgesia
Degree of satisfaction
作者简介
肖峰,男,(1982-),硕士,主治医师,研究方向:医疗卫生管理及临床麻醉与疼痛;通信作者:罗芳,luofangwt@yahoo.com。
