自控式镇痛泵在髋关节置换术后的应用及护理

The Application and Nursing Care of Self-control Analgesia Pump on Hip Replacement Operation

目的：探讨髋关节置换术后应用自控式镇痛泵（ PCA）的镇痛效果及护理要点。方法：将2012年1∽12月收治的120例髋关节置换术患者随机分为两组，观察组60例，术后用自控式镇痛泵镇痛；对照组60例，术后用阿片类药物镇痛。比较两组的镇痛效果和药物不良反应。结果：观察组术后0-Ⅰ级疼痛56例，Ⅱ-Ⅳ级疼痛4例，发生药物不良反应4例；对照组术后0-Ⅰ级疼痛34例，Ⅱ-Ⅳ级疼痛26例，发生药物不良反应15例。切口疼痛（Ⅱ-Ⅳ级）发生率观察组占6.7％，对照组占43.3％；药物不良反应发生率观察组占6.7％，对照组占25％，两组比较差异有统计学意义（P 〈0.05）。结论：髋关节置换术后应用自控式镇痛泵镇痛效果确切，值得在临床推广。

Objective：To investigate the analgesic effects and the nursing vital points for the patients taken the self-control analgesia pump（PCA）after hip replacement. Methods：120 cases of hip replacement patients in our hospi-tal,were randomly divided into two groups from January to December in 2012. The experimental group of 60 cases were taken by self-control analgesia pump to relieve the pain after the operation,while the control group of 60 cases were a-dopted the opioid drugs to relieve the pain. The results were observed to compare the analgesic effect and adverse drug reactions. Results：In the experimental group,56 cases of postoperative were Level 0-Ⅰpain,4 cases were LevelⅡ- Ⅳpain,and 4 cases were adverse drug reactions;in the control group,34 cases were Level 0 - Ⅰpain,26 cases were LevelⅡ - Ⅳ pain,and 15 cases were adverse drug reactions. The percent of pain of incision was（LevelⅡ - Ⅳ ） 6. 7% in the experiment group,while 43. 3% in the control group. The percent of adverse drug reaction was 6. 7% in the experiment group,while 25% in the control group. There was a statistically significant difference（P 〈 0. 05）. Con-clusion：Considering the significant effects,the self-control analgesia pump（PCA）after hip replacement is worth pro-moting. However,pertinent nursing care should be carried out just because analgesic medicines have relative side effects and adverse reaction.