快速康复外科理念指导下的多模式疼痛护理在多发肋骨骨折患者围术期中的应用

Application of Multimodal Pain Nursing under Enhanced Recovery After Surgery Concept in Patients with Multiple Fractured Ribs during Perioperative Period

目的:探讨快速康复外科理念指导下的多模式疼痛护理对多发肋骨骨折患者围术期疼痛及疼痛控制满意度的影响。方法:随机将收治的75例多发肋骨骨折患者分为对照组和观察组。对照组38例,在围术期实施常规疼痛护理;观察组37例,实施快速康复外科理念指导下的多模式疼痛护理。比较两组患者术前1 d及术后1 d、2 d、3 d、7 d疼痛评分,术前1 d及术后7 d疼痛因子水平,术后7 d疼痛控制满意度。结果:两组患者术前1 d视觉模拟评分法(VAS)评分、血清5-羟色胺(5HT)、去甲肾上腺素(NE)比较,差异无统计学意义(P>0.05);术后1 d、2 d、3 d、7 d观察组VAS评分明显低于对照组,差异有统计学意义(P<0.05);术后7 d,观察组5HT、NE水平明显低于对照组,差异有统计学意义(P<0.01),疼痛控制满意度评分高于对照组,差异有统计学意义(P<0.01)。结论:以快速康复外科理念为指导的多模式疼痛护理可以有效减轻多发肋骨骨折围术期患者疼痛感受,提高疼痛控制满意度。

Objective To investigate the effect of multimodal pain nursing under Enhanced Recovery After Surgery concept on pain and satisfaction with pain control in patients with multiple fractured ribs during perioperative period.Method 75 patients with multiple fractured ribs were enrolled and randomly divided into control group and observation group.38 patients in the control group who received routine pain nursing during perioperative period,and 37 patients in the observation group who received multimodal pain nursing under enhanced recovery after surgery concept.The scores of pain on the first day before surgery and the first day,second day,third day and seventh day after surgery,the levels of pain factor on the first day before surgery and seventh day after surgery,and satisfaction with pain control on the seventh day after surgery were compared between the two groups.Results There were no significant difference in the VAS scores and the levels of 5-HT、NE on the first day before surgery between the two groups(P>0.05).The VAS scores on the first day,second day,third day and seventh day after surgery and the levels of 5-HT、NE on the seventh day after surgery in the observation group were significantly lower than those in the control group(P<0.05).And the satisfaction with pain control on the seventh day after surgery in the observation group were significantly higher than those in the control group(P<0.01).Conclusion Multimodal pain nursing under Enhanced Recovery After Surgery concept can significantly reduce the pain feeling of patients with multiple fractured ribs during perioperative period,and improve the satisfaction of pain control.