多学科协作诊疗模式在创伤性骨折患者治疗中应用对缓解疼痛和心理应激反应的效果

Effect of multi-disciplinary collaborative diagnosis and treatment on pain relief and stress response in patients with traumatic fractures

目的探讨多学科协作诊疗模式(multiple disciplinary teamn,MDT)在髖部创伤性骨折患者围术期应用的镇痛、缓解心理应激反应的价值。方法选取2016年2月-2018年2月秦皇岛市骨科医院收治的髖部创伤性骨折患者80例,依据随机数字法分成两组,对照组(40例)围术期采用传统诊疗模式,观察组(40例)实施MDT模式,对比两组患者干预前、术后疼痛程度和心理状态的变化,记录两组患者感染等并发症发生率、创面愈合时间情况。结果两组患者干预前视觉模拟评分(visual analogue scale,VAS)、焦虑自评量表(elf-rating anxiety scale,SAS).抑郁自评量表(self-aing depression scale,SDS)评分差异无统计学意义(P>0.05);术后1d时、3d时观察组VAS降幅高于对照组,术后1周、2周时观察组SAS、SDS评分显著低于对照组(P<0.05);观察组患者住院时间短于对照组,感染以及其他类并发症发生率低于对照组(P<0.05)。结论MDT应用于髋部创伤性骨折患者中可更好的缓解其疼痛、疏导负性情绪,促进术后机体的恢复,降低并发症发生率。

Objective To explore the value of multiple disciplinary team(MIDT)in the perioperative application of analgesia and relieve psychological stress in patients with hip traumatic fracture.Methods 96 patients with hip traumatice fractures admitted to Qinhuangdao Orthopaedie hospital from February 2016 to February 2018 were selected as subjects.After exclusion criteria,80 patients were divided into two groups according to the numerical randomization method.The control group(40 cases)The perioperative period was based on the traditional diagnosis and treatment model.The observation group(40 cases)underwent MDT mode,The changes of pain level and psychological state before and after intervention were compared between the two groups.The incidence of complications such as infection and wound healing time were recorded.Results There were no diferences in the visual analogue scale(VAS),self-rating anxielty scale(SAS),and self-rating depression scale(SDS)scores between the two groups.Statstical significance(P>0.05);the VAS of the observation group was higher than that of the control group at 1d and 3d after operation,and the SAS and SDS scores of the observation group were significantly lower than those of the control groupal 1 and 2 weeks after operation(P<0.05).The hospitalization time of the observation group was shoter than that of the control group,and the incidence of infection and other complications was lower than that of the control group(P<0.05).Conclusions MDT can better alleviate pain,dilute negative emotions,promote postoperative recovery and reduce the incidence of complications in patients with hip traumatic fractures.