循证理念指导下的疼痛管理在烧伤整形植皮手术患者中的应用

Application of Pain Management under the Guidance of Evidence-based Concepts in Patients Undergoing Burn Plastic Skin Grafting Surgery

目的:探索循证理念指导下的疼痛管理在烧伤整形植皮手术患者中的应用。方法:前瞻性选取2023年1-12月三明市第一医院烧伤科收治的120例烧伤整形植皮手术患者。随机将其分为对照组与护理组,各60例。对照组实施常规疼痛管理,护理组实施循证理念指导下的疼痛管理。比较两组术后情况,术后12 h、72 h的疼痛程度,护理前后心理状态及并发症。结果:护理组发热消失时间及创面愈合时间均显著早于对照组,差异有统计学意义(P<0.05),两组瘢痕指数、植皮成活创面覆盖率比较,差异无统计学意义(P>0.05)。术后72 h,护理组视觉模拟评分法(VAS)评分低于对照组,差异有统计学意义(P<0.05)。护理后,护理组汉密尔顿抑郁量表(HAMD)与汉密尔顿焦虑量表(HAMA)评分均低于对照组,差异有统计学意义(P<0.05)。护理组术后并发症发生率为6.67%,低于对照组的21.67%,差异有统计学意义(P<0.05)。结论:循证理念指导下的疼痛管理应用于烧伤整形植皮手术患者中可促进术后恢复,减轻疼痛程度,缓解焦虑、抑郁,并减少并发症发生。

Objective:To explore the application of pain management under the guidance of evidence-based concepts in patients undergoing burn plastic skin grafting surgery.Method:A total of 120 patients undergoing burn plastic skin grafting surgery were prospectively selected from January to December 2023 in the Burn Department of Sanming First Hospital.They were randomly divided into control group and nursing group,60 cases in each group.The control group implemented routine pain management,and the nursing group implemented pain management under the guidance of evidence-based concepts.The postoperative conditions,pain degree at 12 h and 72 h after surgery,psychological state before and after nursing and complications were compared between the two groups.Result:The fever disappearance time and wound healing time in the nursing group were significantly earlier than those in the control group,the differences were statistically significant(P<0.05),but there were no statistically significant differences in scar index and coverage rate of viable skin grafts between the two groups(P>0.05).At 72 h after surgery,the visual analogue scale(VAS)score of the nursing group was lower than that of the control group,and the difference was statistically significant(P<0.05).After nursing,the Hamilton depression rating scale(HAMD)and Hamilton anxiety rating scale(HAMA)score of the nursing group were lower than those of the control group,and the difference was statistically significant(P<0.05).The incidence of postoperative complications in the nursing group was 6.67%,which was lower than 21.67%in the control group,and the difference was statistically significant(P<0.05).Conclusion:Pain management under the guidance of evidence-based concepts can promote postoperative recovery,reduce the degree of pain,relieve anxiety and depression,and reduce the occurrence of complications in burn plastic skin grafting surgery patients.