微信在术后使用PCEA患者中的应用

Application of Wechat in Patients Treated with Postoperative Epidural Controlled Analgesia(PCEA)

目的探讨微信教育在术后患者使用硬膜外自控镇痛(PCEA)期间的意义。方法将200例术后需使用PCEA的患者分为两组,对照组100例为病房护士常规教育组,观察组100例为急性疼痛服务小组(APS)进行微信教育组。对照组进行常规教育,微信教育组在常规教育的基础上,在使用PCEA期间以微信进行教育,直至拔管后24小时结束。结果对两组患者镇痛效果的比较差异有统计学意义(P<0.001),观察组优于对照组。两组患者不良反应发生率比较,发现对照组和观察组的恶心、呕吐、瘙痒的发生率相当,两组比较差异无统计学意义(P>0.05)。对两组患者导管护理情况的比较,发现对照组和观察组的导管拔出、泵遗失的发生率相当,两组比较差异无统计学意义(P>0.05),而对照组导管移位发生率为16%,观察组为4%,对照组发生导管移位率高,两组比较差异有统计学意义(P<0.01)。比较两组患者满意度,发现对照组满意率86%,观察组满意率100%,两组比较差异有统计学意义(P<0.001),观察组满意率高。结论对于术后使用PCEA期间以微信教育,可提高患者对疼痛的认识及自我管理、护理能力,提高镇痛效果,减少导管移位发生率;极大程度的提高了患者满意度。

Objective To discuss the application effect of Wechat education in patient treated with postoperative epidural controlled analgesia （PCEA）. Methods In total of 200 postoperative patients who need treated with PCEA were divided into two groups, control group and observation group. 100 patients in control group were educated routinely by nurses. 100 patients in observing group were educated by acute pain service group （APS） through Wechat. Routine education was adopted in control group and routine education combined with Wechat education during PCEA treatment until 24 hour after extubation was adopted in observation group. Results There was statistically significant difference in analgesic effect of the two groups （P〈0.001）, and the analgesic effect of observation group was better than that of control group. According to the comparison of incidence rates of adverse reactions in the two groups, incidence rates of nausea, vomiting and pruritus in the two group were similar, and the differences were not statistically significant （P〉0.05）. According to the comparison of catheter care in the two groups, catheter extraction rate and pump loss rate in the two groups were similar, and there were no statistically significant differences （P〉0.05）. Catheter displacement rate in control group was 16%, and in observation group it was 14%. Catheter displacement rate in control group was higher, and the difference was statistically significant （P〈0.01）. According to the comparison of satisfaction degree, satisfaction rate in control group was 86% and in observation group was 100%. Satisfaction rate in observation group was higher and the difference was statistically significant （P〈0.001）. Conclusion Wechat education among postoperative patients treated with PCEA can improve the awareness of pain, self-management ability and nursing ability of patients, improve effect of analgesia, reduce the incidence rate of catheter displacement and increase satisfaction rate of patients.