胃肠道疾病患者围手术期疼痛现状调查分析

Survey and Analysis on the Pain Status in Perioperative Period in Patients with Gastrointestinal Diseases

目的调查胃肠道疾病患者围手术期的疼痛状况,为建立无痛病房,优化医疗和护理服务提供依据。方法对2011年12月5日-2012年1月14日胃肠外科所有的新住院患者共227例,采用《四川大学华西医院住院病人疼痛现状调查问卷》进行调查,并同期调查胃肠外科27名主管医师对疼痛药物了解状况。结果有明确行为能力的216例患者完成调查问卷,其中有195例(90.28%)接受手术治疗,全身麻醉患者193例(占手术患者98.97%),诊断为胃肠道肿瘤163例(占手术人数的83.59%),手术等级为三级146例(占手术人数的74.87%)。有168例(86.15%)患者术后镇痛,在术后镇痛过程中使用镇痛泵156例(92.86%),其中75例(48.08%)认为镇痛泵镇痛"基本有效",30例(19.23%)认为"无效"。39例术后未使用镇痛泵,其中20例(51.28%)认为"未使用术后镇痛泵"最主要原因为"不了解镇痛泵"。受调查的主管医师了解的疼痛药物仅占罗列药物52种的(20±5.36)种。结论疼痛现象在胃肠道疾病围手术期患者中属普遍现象,由于不断增强镇痛意识和镇痛需求与相关知识缺乏的矛盾存在,及较少的医疗护理干预,导致镇痛效果不佳,影响了疼痛管理长效机制的建立和无痛病房的建设。

Objective To explore the pain status in perioperative period in patients with gastrointestinal diseases, and to establish the pain-free wards and optimize the medical and nursing service. Methods Between December 5, 2011 and January 14, 2012, a total of 216 in-patients with were investigated by designed questionnaire about their pain status. Results The result showed the percentage of patients who had suffered from the pain before and after surgery, effect of used analgesic drugs, and the percentage of patients requiring pain intervention. Conclusions The pain is very common among patients with gastrointestinal diseases inin perioperative period. Due to the lack of relevant knowledge of pain management and deficient medical and nursing intervention, the current analgesic effect is still not very promising to set up the pain-free wards and the permanent mechanism of pain management.