PCA对缓解术后患者疼痛的分析

Patient-Controlled Analgesia Pump on Patients' Post-Operation Pain Control

目的 构建普外科手术患者PCA镇痛健康培训方案,应用并检验其疼痛控制效果.方法 本次研究为前后对照研究（非同期对照实验）.健康培训方案实施前（2013年6～11月）,通过文献回顾构建PCA健康教育方案,责任护士根据护理规范对200例患者进行常规护理,为对照组;健康培训方案实施阶段（2013年12月～ 2014年5月）,责任护士运用PCA对200例患者进行护理,为观察组.结果 在实施自控镇痛泵健康培训后,患者掌握程度由干预前的82.33分增长到干预后的94.79分.干预后,观察组患者的知识掌握程度得分（94.79分）较对照组患者（80.14分）提高了14.65分,具有显著性差异.干预后,观察组较对照组,自控镇痛泵药物使用量由86.66ml增加到92.34ml.干预后,患者疼痛程度显著降低,由中度疼痛（5.33分）降至轻度疼痛（2.49分）,具有统计学意义.结论 责任护士实施患者自控镇痛泵健康培训方案,能有效提升患者自控镇痛泵知识掌握程度,增加患者信念,从而改变镇痛泵使用行为,降低术后疼痛.

Objective This study used a pre - and post - contract design （ non - concurrent control trial）. Before the im- plementation of the health education program （ June to November 2013 ） , PCA health education program was established through a literature review. According to the nursing care guideline, 200 patients received routine care, which was the control group. Dur- ing the health education program implementation phase （ December 2013 to May 2014 ） , 200 patients received nursing care using PCA, which was the observation group. Method Using competency theory as guidance, and the post requirements of level - nl nurse as orientation, two rounds of expert consultation were performed by Delphi method. Result After the implementation of PCA health education program, the mastery level of patients increased from 82.33 points to 94.79 points. After the intervention, knowledge of the patients in the observation group was significantly higher than that of the control group by 14.65 points （94.79 vs. 80.14 points, P 〈 0.05 ）. Furthermore, the amount of drug use in the observation group was significantly higher than that of the control group （ 92.34 vs. 86.66 ml, P 〈 0.05 ） , and the degree of pain was significantly reduced from moderate pain to mild pain （ 5.33 vs. 2.49 points, P 〈 0.05 ） . Conclusion The implementation of PCA health education program can effectively im- prove the knowledge of patients on PCA and increase patient beliefs, which can change the usage behavior on PCA, and ultimately reduce postoperative pain.