规范化疼痛护理管理对肋骨骨折患者围手术期疼痛的影响

Influence of Standardized Pain Nursing Management during Perioperative Period for Patients with Rib Fracture

目的:探讨规范化疼痛护理管理对肋骨骨折患者围手术期疼痛的影响。方法:选取2015年6月1日-2016年5月31日于本院治疗的60例肋骨骨折手术患者,采用随机数字表法分为对照组和试验组,每组30例。对照组采用肋骨骨折传统常规护理,试验组在常规护理的基础上给予规范化疼痛护理管理措施。对两组术前晚、术后各时间点的疼痛程度评分、肺功能锻炼依从性、肺部并发症发生率、住院天数及患者镇痛满意度,术后48 h内追加按压镇痛泵例数及术后72 h内使用氟比洛芬酯超前镇痛的人数进行比较分析。结果:试验组术前晚、术后8、16、24、48、72 h时间点疼痛程度评分、肺部并发症发生率、住院天数均低于对照组,肺功能依从性、患者镇痛满意度均优于对照组,术后48 h内追加按压镇痛泵例数及术后72 h内使用氟比洛芬酯超前镇痛的例数多于对照组,差异均有统计学意义(P<0.05);但两组患者手术安返病房时疼痛程度评分比较,差异无统计学意义(P>0.05)。结论:规范化疼痛护理管理,使肋骨骨折患者围手术期疼痛被充分认识和治疗,能有效缓解患者疼痛,从而提高患者早期下床活动与肺功能锻炼的依从性,降低肺部并发症,缩短住院时间。

Objective： To investigate the influence of standardized pain nursing management during perioperative period for patients with rib fracture.Method： From June 1st 2015 to May 31th 2016, 60 rib fracture patients treated in our hospital were selected and divided into the control group and the experimental group according to the random number table method, 30 patients in each group.The control group received traditional routine nursing, while the experimental group received standardized pain management on the basis of routine nursing. The degree of pain, lung function, exercise compliance, pulmonary complications, length of hospital stay, satisfaction degree of analgesia, the additional push times of analgesic pump in 48 hours after operation and the number of use preemptive analgesia with Flurbiprofen axetil in 72 hours after operation of two groups were compared and analyzed.Result： On the night before surgery, in 8, 16, 24, 48 and 72 h after surgery, the degree of pain, incidence of pulmonary complications and the length of hospital stay of the experimental group were lower than those of the control group, lung function compliance and the analgesic satisfaction were better than those of the control group, additional push times of analgesic pump in 48 hours after operation and the number of use preemptive analgesia with Flurbiprofen axetil after 72 h of the experimental group were higher than those of the control group, the differences were statistically significant （ P〈O.05 ） .But there was no significant difference in pain score between two groups when patient returned to the ward after operation （P〉O.05） .Conclusion： Standardized pain nursing management can make rib fracture patients＇ pain be awared fully, and receive adequate treatment during perioperative period, make patients ambulation early and improve their lung functiong exercise compliance by relieve their pain effectively, which can decrease pulmonary complications and shorten hospitalization time.