骨折患者围术期疼痛规范化管理临床效果分析

Analysis of the clinical effect of standardized perioperative pain management in patients with fracture

目的：探讨骨折患者围术期疼痛规范化管理的临床效果。方法：将2013年7月185例骨折手术患者作为对照组，采用常规疼痛管理方法；将2013年10月205例患者作为干预组，组成以护士为基础、麻醉科医生与临床医生共同指导的疼痛管理小组，实施规范化的疼痛干预。观察两组患者不同时间点的疼痛强度、睡眠时间和镇痛满意度。结果：干预组术后VASmax、围术期VASmean及PVAS〉3均低于对照组（P〈0．01），术前1d～术后3d的睡眠时间较对照组延长（P〈0．01），疼痛管理最终满意度为较对照组明显提高（P〈0．01）。结论：围术期疼痛规范化管理有效降低了患者急性疼痛强度，保证了患者充足的睡眠时间，提高了患者对镇痛管理的满意度。

Objective：To investigate the clinical effect of standardized perioperative pain management in patients with fracture. Meth- ods：IS5 patients who underwent surgery for fracture in July 2013 were taken as the control group and the conventional approach to pain management was implemented in this group ;205 patients who received operation in October 2013 were taken as the intervention group and the standardized pain intervention was carried out by the pain management team which was composed of nurses, anesthesiologists and clini- cians. The pain intensity at different time points, hours of sleep of the patients and patient satisfaction with analsgisia were observed in both groups. Results ：The VASmax after surgery,perioperative VASmean and PVAS 〉 3 were lower in the intervention group than those in the control group（ P 〈 0.01 ） ;the sleep time of the patients one day before operation and 3 days after operation was longer in the intervention group than the control group（P 〈 0.01） ;the final satisfaction with pain management was higher in the intervention group than the control group（P 〈0.01）. Conclusion：The standardized perioperative pain management can effectively reduce the acute pain intensity of the pa- tients,ensure the patients adequate sleep time and improve the patient satisfaction with analsgisia.