基于数字智能化的自控镇痛对老年髋部骨折患者内固定术后疼痛康复及不良反应的影响

Effects of patient-controlled analgesia based on digital intelligence on pain rehabilitation and adverse reactions in elderly patients with hip fractures after internal fixation surgery

目的观察并比较智能化患者自控镇痛(Ai-PCA)与常规患者自控镇痛(PCA)对老年患者髋部骨折内固定手术后患者疼痛康复及不良反应的影响。方法选取2018年1月—2022年12月于上海市第六人民医院行髋部骨折内固定手术并于术后行自控静脉镇痛的160例老年患者作为研究对象,分为Ai-PCA组(采用Ai-PCA处理,n=80)和PCA组(采用PCA处理,n=80)。比较2组镇痛开始后12、24、48 h疼痛数字评分量表(NRS)评分、中重度疼痛(NRS≥4分)发生率、镇痛不良反应及患者整体的满意度情况。结果与PCA组比较,Ai-PCA组患者在镇痛开始后12 h时NRS评分差异无统计学意义(P>0.05),而24 h及48 h时NRS评分显著降低(P<0.05);Ai-PCA组患者出院时中重度疼痛的比率、镇痛后恶心呕吐及头晕的发生率显著下降(P<0.05),而瘙痒、过度镇静及呼吸抑制评估值差异均无统计学意义(P>0.05);Ai-PCA组患者整体镇痛满意率显著升高(P<0.05)。结论Ai-PCA镇痛系统可协助医护人员提高髋部骨折内固定手术老年患者术后镇痛效果及整体满意度,并在一定程度上减少镇痛相关不良反应发生,具有一定的临床应用价值。

Objective To observe and compare the effects of artificial intelligent patient-controlled analgesia(Ai-PCA)and conventional patient-controlled analgesia(PCA)on pain recovery and adverse reactions in elderly patients with hip fractures after internal fixation surgery.Methods 160 elderly patients who underwent internal fixation surgery for hip fracture and received postoperative patient-controlled intravenous analgesia in Sixth People s Hospital of Shanghai City from January 2018 to December 2022 were selected as the study subjects.They were divided into Ai-PCA group(n=80)and PCA group(n=80).The pain numerical rating scale(NRS)score at 12,24 and 48 h after the onset of analgesia,as well as the incidence of moderate to severe pain(NRS≥4 points),adverse reactions induced by analgesia and overall patient satisfaction were compared between the two groups.Results There was no statistically significant difference in NRS score between the two groups at 12 hours after the onset of analgesia(P>0.05),but NRS scores of the Ai-PCA group were significantly lower than those of the PCA group at 24 and 48 hours(P<0.05).Compared with the PCA group,the rate of moderate to severe pain at discharge and the incidence of nausea,vomiting and dizziness after analgesia of the Ai-PCA group decreased significantly(P<0.05),while there was no statistically significant difference in the assessment values of itching,excessive sedation and respiratory depression(P>0.05).The overall patient satisfaction rate of pain relief of the Ai-PCA group increased significantly(P<0.05).Conclusion Ai-PCA analgesic system can help medical staff improve the postoperative analgesic effect and overall satisfaction of elderly patients with hip fractures after internal fixation surgery,and reduce the occurrence of analgesia-related adverse reactions to a certain extent,which has certain clinical application value.