长骨干骨折病人救治中镇痛方案的临床研究

THE ANALGESIC STRATEGY FOR PATIENTS SUFFERING FROM LONG-BONE FRACTURE

目的:观察不同镇痛方案对长骨干骨折病人的镇痛效果及安全性。方法:以2002年～2005年入住我院的肱骨、尺桡骨、股骨、胫腓骨等长骨干骨折患者174例为研究对象,分别在院前急救与院内救治过程中采用不同镇痛方案,观察镇痛前后VAS评分,记录患者主观满意度和镇痛处理的不良反应。结果:院前肌肉注入镇静镇痛药可明显减轻疼痛,并可提高入院后治疗中的疼痛耐受性。院内救治中采用区域神经阻滞较全身用药效果更佳,病人满意度更高。所有研究对象均未出现镇痛处理引发的安全问题。结论:长骨干骨折病人早期急救过程中及时恰当地应用镇痛技术,可使之平静安全地渡过疼痛期,在较少的痛苦中获得创伤救治。

Objective ： To observe the effect and safety of different analgesic strategy on patients suffering from long-bone fracture. Methods： 174 patients in our hospital undergoing fracture in humerus, ulna, radius, femur, tibia or fibula from year 2002 to 2005 were involved in the study. The patients received different analgesic strategies in their first aid out of hospital and in the secondary medical care in the hospital. The changes of visual analogue score （VAS） and the satisfactory degree were recorded before and after analgesic treatment, respectively. Results： Patients with diazepam, bucinperazine or kitamin muscular injection out of hospital showed less pain and higher tolerance to pain maragement in the secondary medical care in the hospital. For the analgesic treatment in hospital, local nerve blockage was more effective than systemic administration of drugs. None of patients showed safety problem due to analgesic treatment. Conclusion： Appropriate analgesic treatment given as early as possible could help the patients safely pass the acute pain period and accept further treatment with less suffering.