自控静脉镇痛泵在剖宫产术后护理中的应用价值

Patient controlled intravenous analgesia's value in postoperative care of cesarean section

目的 探讨自控静脉镇痛泵在剖宫产术后护理中的应用及其对产妇焦虑情绪的影响.方法 选取择期剖宫产术后产妇600例,随机分为观察组和对照组各300例,对照组术后给予哌替啶肌肉注射镇痛;观察组术后应用自控静脉镇痛泵,术后保留36小时,比较两组的疼痛程度、镇静（Ramsay）评分、焦虑自评量表（SAS）评分,于产妇出院前行护理满意度评价.结果 对照组Ⅰ级、Ⅱ级疼痛比例均低于观察组（P＜0.05或P＜0.01）,而Ⅲ级、Ⅳ级疼痛比例均高于观察组（P＜0.01）.对照组Ramsay评分1分的比例显著高于观察组（P＜0.01）,2分的比例低于观察组（P＜0.05）,而两组3～6分的比例差异无统计学意义（P＞0.05）.对照组与观察组SAS评分分别为（21.05±4.58）和（11.35±2.16）分（t=4.92,P＜0.05）,护理满意度分别为（97.9±1.3）％和（90.0±2.5）％,差异均具有统计学意义（t=4.51,均P＜0.05）.结论 自控静脉镇痛泵在剖宫产术后护理中的应用具有较好的效果,有效缓解了产妇的术后疼痛和焦虑,在密切的护理监护措施和护理干预下,有效预防了相关并发症的发生,对剖宫产术后护理具有一定的指导和借鉴意义.

Objectives To explore patient controlled intravenous analgesia （PCIA）＇s application in postoperative care of cesarean section and its influence on maternal anxiety. Methods 600 patients after elective cesarean section were randomly divided into observation group and control group. Puerpera in control group were given intramuscular analgesia by pethidine after cesarean section, yet puerpera in observation group were given PCIA after cesarean section, and were reserved for 36h. After 36h, two groups＇ pain, calm score （Ramsay） and self rating Anxiety Scale （SAS） score were compared, and nursing satisfaction were evaluated before puerpera＇s discharge. Results Pain ratio of grade I and [l in control group were lower than those in that in observation group（P〈0, 05 or P〈0. 01）. The grade Ⅲ and Ⅳ in control group were higher than that in observation group（P〈0.01）. Ratio of 1 point of Ramsay score in control group were obviously higher than that in observation group（P〈0.01）. The ratio of 2 point were lower than that in observation group （P〈0.05）, and there were no difference on ratio from 3 point to 6 point in two groups （P〉0. 05）. SAS scores in control group and observation group were （21. 054±4.58） and （11.35±2. 16） （t=4.92,P〈0.05）, and nursing satisfaction were （97.9±1.3）% and （90.0±2.5）% （t=4.51,P〈0.05）. Conclusion It has good effect of PCIA＇s application in postoperative care of cesarean section, and it can effectively relieve the postoperative pain and anxiety. In close nursing care and nursing intervention, it effectively prevents related complications.