《创建泌尿系结石患者急性疼痛的规范化管理模式的研究》.docxVIP

创建泌尿系结石患者急性疼痛的规范化管理模式的研究徐成维 四川省广元市中心医院急诊科 摘要目的规范泌尿系结石患者急性疼痛管理，提高镇痛效果。方法组建在科室主任、护士长督导下主管医生与专科护士为主体护理模式，制定小组成员职责，规范运作流程，包括制定镇痛护理方案，辅助镇痛支持，疼痛查房，“一对二”个性化疼痛健康教育，疼痛工作经验交流等。结果（1）观察组患者2-8h、9-24h及24h后疼痛均明显低于对照组，差异有统计学意义（t=-2.961、-3.258、-3.122，P0.05）；（2）观察组疼痛完全缓解（0 度）39例，完全缓解率达73.58%，对照组完全缓解（0 度）27例，完全缓解率为50.94%，组间比较差异有统计学意义（Z=-2.890，P=0.004）；（3）观察组患者对疼痛管理模式评价总分为14.18±1.82分，在增进舒适度、缓解紧张、促进放松、减轻疲劳评分均在3分以上。结论创建泌尿系结石患者急性疼痛的规范化管理模式可以提高镇痛质量。关键词急性疼痛；泌尿系结石；镇痛；疼痛管理Establishment and practice of acute-pain management model for acute pain of urinary calculusAbstract Objective To standardize management of acute-pain management model and to improve effect of acute pain of Urinary calculus. Methods A nurse and doctor-base, department director and head nurse-supervised organization was established, in which personnel responsibility was formulated, and operational processes were improved. Then the development of nursing program, auxiliary support, preoperative visits, One to two pain education, pain experience exchange were reported and handled. Results (1) The pain score of observation group were during 2-8h, 9-24h and 24h significantly lower than the control group（t=-2.961、-3.258、-3.122，P0.05）;(2)39 cases of complete remission in observation group, the complete remission rate was 73.58%, and 27 cases of complete remission in control group, the complete remission rate was 50.94%, there was statistically significant difference between groups（Z=-2.890，P=0.004）; (3)Theevaluation of pain management was 14.18 ±1.82 in observation group, in promoted comfortable,eased the tension, promoted relaxation, relieved fatigue were above 3 points.Conclusion Establishment acute-pain management model can improve the quality of analgesia.Key words Urinary calculus; acute pain; analgesia; pain management目前，随着疼痛研究的不断深入，新型止痛药不断出现，临床疼痛治疗取得极大发展，但临床中镇痛不足情况仍存在[1]。而影响疼痛的因素，如疼痛处理欠规范，医护人员疼痛知识缺乏等[2]。疼痛是泌尿系结石是主要症状，临床表现为腰腹部突发性绞痛，疼痛感极强。为缓解疼痛，规范化疼痛管理不容忽视[3]。为了使泌尿系结石患者得到专业化的疼痛治疗，本研究于2012年6月创建规范化疼痛管理模式，成立疼痛管理小组，为其疼痛进行护理，取得满意