急诊创伤患者疼痛控制现状及影响因素研究

Research of emergency trauma patients pain control and influencing factors

目的研究急诊创伤患者疼痛控制现状及影响因素,改善临床疼痛控制。方法采用VRS-6和FRS对患者抢救过程中疼痛控制进行评估。结果护士对疼痛控制的预期评价与患者自评疼痛VRS-6评价一致性差(kappa=0.47),不同MEWS分层患者镇痛处理率、疼痛控制满意率比较,差异均有统计学意义(P<0.05),MEWS 3~4分、5~6分患者的护士预期疼痛显著低于患者实际疼痛。MEWS、主要损伤部位和多处创伤是影响急诊疼痛控制的主要因素(OR=2.165、1.921、2.102,P<0.05)。结论急诊护士具有较普遍创伤患者疼痛控制意识,但存在局限,疼痛控制受到护士积极性、患者生命体征、伤情影响。

Objective To study the emergency trauma patients pain control a^ld influencing factors, improved clinical pain control. Methods VRS-6 and FRS rescue process for patients to assess pain control. Results The nurses were ex- pected to evaluate pain control and patient self-assessment of pain VRS-6 Evaluation poor agreement （kappa=0.47）, in patients with different hierarchical MEWS analgesic treatment rate, pain control satisfaction rate, the difference were statistically significant （P 〈0.05）, MEWS 3 to 4 points, 5 to 6 points the patient＇s nurse expected pain were sig- nificantly lower than real pain in patients. MEWS, the main site of injury and multiple trauma were the the main fac- tors affecting emergency pain control（OR = 2.165,1.921,2.102, P 〈0.05）. Conclusion The emergency nurses a more general sense of pain control in trauma patients, hut there is limit, pain control is affeeted by nurses enthusiasm, pa- tient vital signs and injuries.