前馈控制护理干预在行胸腔镜肺叶切除术使用术后静脉自控镇痛泵患者中的应用效果

Effects of nursing intervention under feedforward control on postoperative patient controlled intravenous analgesia in patients undergoing thoracoscopic lobectomy

目的:探讨前馈控制下的护理干预措施对胸腔镜肺叶切除术患者术后使用静脉自控镇痛效果的影响。方法:选取2018年10月—2019年9月于山西白求恩医院行胸腔镜肺叶切除术且术后使用静脉自控镇痛(PCIA)泵的60例患者,采用随机数字表法随机分为对照组和试验组,各30例。对照组给予常规护理,试验组采用前馈控制下的护理干预措施。分别采用VAS评分和Ramsay评分评估两组患者术后12、24、36、48 h的镇痛及镇静情况,记录镇痛泵药物使用剂量和镇痛泵自控按压次数以及术后48 h内的不良反应发生情况,并对护理满意度进行评分。结果:试验组术后12、24、36、48 h的VAS评分低于对照组,Ramsay评分高于对照组,差异均有统计学意义(P<0.05)。试验组的镇痛泵药物使用剂量及镇痛泵自控按压次数少于对照组,患者总满意度评分高于对照组,不良反应发生率低于对照组,差异均有统计学意义(P<0.05)。结论:胸腔镜肺叶切除术患者术后镇痛管理中采用前馈控制下的护理干预措施可明显提高患者术后PCIA泵的镇痛效果,能够降低相关不良反应发生率,进一步提高患者满意度,值得应用推广。

Objective To explore the effects of nursing interventions under feedforward control on postoperative patient controlled intravenous analgesia(PCIA)in patients undergoing thoracoscopic lobectomy.Methods Sixty patients who used PCIA pumps after thoracoscopic lobectomy in Shanxi Bethune Hospital from October 2018 to September 2019 were selected and randomly divided into a control group and a test group according to the random number table,with 30 cases in each group.Patients in the control group used PCIA pumps alone,while patients in the test group underwent nursing interventions under feedforward control combined with PCIA pumps.The Visual Analog Scale(VAS)and Ramsay scores were used to assess the analgesia and sedation of the patients in the two groups at 12,24,36,and 48 h postoperatively.The dose of analgesic pump medication,the number of self-controlled compressions of the analgesic pump,and the occurrence of adverse reactions at 48 h postoperatively were recorded.The satisfaction with nursing care was rated.Results The VAS scores at 12,24,36 and 48 h postoperatively in the test group were lower than those in the control group,and the Ramsay scores were higher than those in the control group,and the differences were statistically significant(P<0.05).The dose of analgesic pump medication and the number of self-controlled compressions of the analgesic pump in the test group were less than those in the control group,and the overall patient satisfaction scores were higher than those in the control group,and the incidence of adverse reactions was lower than that in the control group,and the differences were all statistically significant(P<0.05).Conclusions Nursing interventions under feedforward control in the postoperative analgesic management of patients undergoing thoracoscopic lobectomy can significantly improve the analgesic effect of postoperative PCIA pumps,reduce the incidence of related adverse reactions,and further improve patient satisfaction,which is worth applying and promoting.