稿件广州地区创伤患者早期镇痛治疗现状的调查.docxVIP

广州地区创伤患者早期镇痛治疗现状的调查卢魁 郭嘉张秋婷叶志强 王科科 刘宗元 叶雄伟 谭杜勋 谭新宇作者单位：510630 南方医科大学第三附属医院急危重症医学救部（卢魁、刘宗元、叶雄伟、张秋婷、郭嘉、谭杜勋），创伤骨科（谭新宇）；中山大学第一附属医院急诊科（王科科）；中山大学第三附属医院急诊科（叶志强）广州第一作者：卢魁，电话 Email: lk8669090@163.com。通讯作者：谭新宇，Email: tanxy125@126.com [摘要] 目的 了解广州地区创伤患者急诊科镇痛治疗的现状，为规范急诊科镇痛治疗提供依据。方法 对广州地区二级及以上46家医院急诊外科医生采用无记名问卷调查和回顾性分析2013年9月至2014年12月南方医科大学第三附属医院急诊科镇痛治疗的创伤患者。问卷调查内容包括：疼痛分级、镇痛治疗时机、药物选择、适应证、、以及未给予镇痛治疗的原因等。回顾性分析纳入标准：X片或CT检查明确存在骨折、脱位或出血征象。神志清醒，生命体征稳定，ISS评分16-24分。结果 问卷调查共发出问卷220份，收到有效答卷206份，回收率为93.6％。调查结果显示，对于创伤患者立即采取镇痛者仅为4.2％，采用疼痛评分者为48.3％。杜冷丁(52.04％)是首选的镇痛药物。造成延迟或不给予镇痛治疗的担忧主要包括，镇痛治疗干扰对创伤的诊断和病情的观察(42.2％)、镇痛药物造成呼吸抑制(35.5％)等。回顾性分析结果显示，仅47.8%的创伤患者在急诊科获得药物镇痛。女性患者中76.6%获得镇痛，远远高于男性患者，差异具有统计学意义。四肢脊柱部位受伤容易得到镇痛，而腹部受伤极少得到镇痛。结论 广州地区急诊科在诊治创伤镇痛时很少实施镇痛治疗。急诊外科医生镇痛知识陈旧，过度强调镇痛药物副作用。表明急诊科加强镇痛治疗培训和继续教育的迫切性和重要性。[关键词] 广州；急诊；创伤；镇痛Investigation on the analgesia for traumatic patients in emergency department in the region of Guangzhou. LU kui, GUO jia, ZHANG qiuting, YE zhiqiang, WANG keke, LIU zongyuan, YE xiongwei, TAN duxun, TAN xinyu. Department of emergency, the Third Affiliated Hospital of Southern Medical University( LU kui, GUO jia, ZHANG qiuting, LIU zongyuan, YE xiongwei, TAN duxun, TAN xinyu). Department of emergency, the Third Affiliated Hospital of Zhongshan University (YE zhiqiang, WANG keke). Department of emergency, the First Affiliated Hospital of Zhongshan University (WANG keke) Guangzhou, 510630, China. Corresponding author: TAN xinyu,Email: tanxy125@126.com 【Abstract】Objective To investigate current situation of analgesia for traumatic patients in emergency department in the region of Guangzhou in order to improve the pain management of traumatic patients in emergency department.Methods Emergency surgeons from 46 hospitals in Guangzhou were inquired with a questionnaire on traumatic pain management. The list of question included mainly pain scores, time of analgesia, analgesic selection and adverse events etc. The traumatic patients, received analgesia in the emerg