无痛病房建立对减轻骨科手外伤患者疼痛临床应用研究.docVIP

无痛病房建立对减轻骨科手外伤患者疼痛临床应用研究 　　【摘要】 目的：探?在骨科建立无痛病房对减轻手外伤患者疼痛的效果。方法：选取2014年1-12月建立无痛病房前手外伤围手术期患者150例为对照组，选取2015年1月-2016年6月建立无痛病房后150例手外伤围手术期患者为观察组，两组入院时均进行首次疼痛评分，观察组在骨科常规治疗的基础上手术，当天及术后3 d通过三阶梯镇痛方案，采取多模式、超前、按时+按需给药以及缓节律呼吸法等无痛治疗管理；对照组按骨科常规治疗护理即在患者疼痛剧烈时按需给药。记录两组在术后3 h～3 d的疼痛评分，发放镇痛效果满意调查表，并对两组断指再植及皮瓣移植成活情况进行分析比较。结果：两组患者入院时疼痛评分比较，差异无统计学意义（P0.05）；观察组实施无痛管理后疼痛评分明显低于对照组（P0.01），满意度明显高于对照组（P0.01），断指再植及皮瓣移植存活率均明显优于对照组（P0.01）。结论：无痛病房的建立可减轻患者疼痛程度，提高手术成功率，增加患者舒适度，提高住院满意度。 　　【关键词】 无痛病房； 手外伤； 疼痛控制 　　Clinical Application of Painless Ward in Pain Relief for Hand Injuries in orthopedic Patients/WEI Gui-zhu，HUANG Juan-juan，LONG Yan-zhen.//Medical Innovation of China，2017，14（27）：078-081 　　【Abstract】 Objective：To explore the effect of painless ward establishment in the department of orthopedics to the pain of hand injury patients.Method：150 hand injury peri-operative patients before the establishment of painless ward from January 2014 to December 2014 as the control group，and from January 2015 to June 2016，after the establishment of painless management ward 150 cases as the observation group.The first time pain score on admission were carried out of two groups，the observation group was operated on the basis of orthopedic conventional treatment，painless treatment managements such as multi-mode，advanced，on-time and on-demand administrations and slow rhythm of breathing were adopted by 3 stage analgesia program on the day of the surgery and in 3 days after the surgery.The control group was nursed as the orthopedic conventional treatment，the patients were on-demand administrated when the pain was sharp.The pain scores of two groups within 3 to 3 days after the surgery were respectively recorded，the analgesic effect satisfaction questionnaire was handed out，the survival and replantation of amputated fingers in two groups were compared and analyzed.Result：The pain scores of patients of two groups had no significant meaning when admitted into the hospital（P0.05），the pain score of the observati