NBASS-APS模式在老年颅脑损伤患者围术期疼痛管理中的应用效果分析

Application effects analysis of NBAPS-APS model in perioperative pain management in elderly patients with traumatic brain injury

目的探究以护士为基础,麻醉医师与专科医生指导的急性疼痛服务模式(NBASS-APS)在老年颅脑损伤(TBI)患者围术期疼痛管理中的应用效果,为治疗该病症提供方法。方法纳入2019年3月—2024年3月在山西省汾阳医院治疗的老年TBI患者80例,所有患者按照随机数表法分为观察组(n=40)和对照组(n=40)。2组在相同治疗的基础上,对照组行常规围术期护理,观察组行NBASS-APS模式下疼痛管理干预。对比2组术后不同时间疼痛程度[采用重症监护疼痛观察工具(CPOT)评估]、神经功能[采用格拉斯哥昏迷评分法(GCS)评估]、术后恢复进程(术后疼痛缓解时间、ICU治疗时间、住院时间),以及护理满意度。结果2组术后7 d CPOT评分达到最低值,且观察组CPOT评分低于对照组(均P<0.05);2组术后3 d、7 d GCS评分升高,观察组GCS评分高于对照组(均P<0.05);观察组术后疼痛缓解时间、ICU治疗时间、住院时间均少于对照组(均P<0.05);观察组护理满意度高于对照组(92.50%vs 67.50%,P<0.05)。结论老年TBI患者接受NBASS-APS模式,可有效缓解老年TBI患者的术后疼痛,改善神经功能,促进术后恢复,并且患者护理满意度较高,具有一定的临床应用价值。

Objective To explore the application effects of nurse-based,anesthesiologist and specialist-supervised acute pain service(NBASS-APS)model in perioperative pain management in elderly patients with traumatic brain injury(TBI),and provide a treatment method for the disease.Methods A total of 80 elderly patients with TBI who were treated in Fenyang Hospital,Shanxi between March 2019 and March 2024 were enrolled.According to random number table method,they were divided into observation group(40 cases)and control group(40 cases).On the basis of the same treatment,the control group received routine perioperative care,while the observation group received pain management intervention under NBASS-APS model.The pain degree[Critical-Care Pain Observation Tool(CPOT)]and nerve function[Glasgow Coma Sale(GCS)]at different time after surgery,postoperative recovery process(pain relief time,treatment time in ICU,length of hospital stay)and nursing satisfaction were compared between the two groups.Results CPOT score of the two groups reached the lowest value at 7 days after surgery,and the observation group was lower than the control group(all P<0.05).GCS scores of the two groups increased at 3 d and 7 d after surgery,and the observation group were higher than the control group(all P<0.05).The postoperative pain relief time,treatment time in ICU and length of hospital stay of the observation group were shorter than those of the control group(P<0.05),and nursing satisfaction of the observation group was higher than that of the control group(92.50%vs 67.50%,P<0.05).Conclusion NBASS-APS model can effectively relieve postoperative pain,improve nerve function and promote postoperative recovery in elderly TBI patients.The patient s satisfaction with nursing care is relatively high.It has certain clinical application value.