早期镇痛及心理干预对重型多发伤患者应激反应的影响

Effect of Early Analgesia and Mental Intervention on Stress Reaction of Multiple Injuries

目的探讨早期镇痛及护理心理干预对降低重型多发创伤患者疼痛及应激反应的有效性。方法 48例重型多发伤患者,随机分为观察组和对照组各24例,观察组在受伤后4 h之内实施镇痛+护理干预,对照组按常规处理。入院当日、24、48 h分别采用疼痛视觉模拟标尺(VAS),焦虑自评量表(SAS)对疼痛进行评分及测评焦虑值;监测入院即刻、24、48 h体温、心率、血压、血氧饱和度的变化,对比分析其差异。结果第24、48 h,观察组疼痛明显减轻(P<0.01),焦虑发生率低于对照组组(P<0.01);观察组体温>38℃、心率>90次/min、血压升高,血氧饱和度<95%的例数显著低于对照组(P<0.05)。结论早期综合疼痛管理可显著减轻重型多发创伤患者的疼痛,减轻创伤刺激及创伤后疼痛刺激所产生的应激反应。

Objective To evaluate the effect of early analgesia and mental intervention on the release of pain and stress reaction caused by severe multiple injuries. Methods Forty eight patients with severe multiple injury were randomly divided into case group and control group with 24 cases in each. The patients in case group were treated by analgesia and mental intervention within 4 hours after admission, and the patients in control group were treated as usual.. The score of VAS and SAS were evaluated. The temperature, heart rate, blood pressure and saturation of blood oxygen were observed at 0 hour, 24 hours and 48 hours after admission. Re- suits The p-value of VAS of case group was less than 0. 01 at 24 hours and 48 hours after admission com- pared with control group. Anxiety incidence rate of case group was less than control group. Other observed indexes of case group were lower than control group. Conclusion Early analgesi more effective on release of pain and stress reaction caused by severe multiple