以护士为主体的多模式镇痛应用于脊柱侧弯患者围手术期的效果评价

发布时间：2018-06-04 01:21

本文选题：多模式镇痛 + 脊柱侧弯　；参考：《山西医科大学》2017年硕士论文

【摘要】：目的:观察以护士为主体的多模式镇痛方法(MMA)应用于脊柱侧弯患者围手术期的效果,探讨脊柱侧弯患者围手术期的多模式镇痛方案的适用性,以期为护理提供科学性的指导和循证依据,减轻患者疼痛,提供优质护理服务,同时探索护士在疼痛管理体系中的作用与意义。对象与方法:采用实验研究的方法。选取2016.5-2017.2在某院拟行脊柱截骨矫形术的脊柱侧弯患者60例为研究对象,2016.5-9的30例患者为对照组,2016.10-2017.2的30例患者为观察组。对照组采用常规按需镇痛护理,观察组采用以护士为主体的多模式镇痛MMA。比较两组患者不同时间点的疼痛评分、S-AI状态焦虑量表评分、镇痛满意度、术后恢复情况及阿片类药物不良反应发生情况,从而观察以护士为主体的MMA应用于脊柱侧弯围手术期患者的效果。采用SPSS软件对数据进行t检验、方差分析、c(17)检验,选择检验水准α=0.05,以P0.05表示差异具有统计学意义。结果:(1)研究对象一般情况:观察组男性13例,女性17例,年龄6-21岁,平均年龄(14.63±3.36)岁;对照组男性11例,女性19例,年龄8-19岁,平均年龄(15.07±2.15)岁。两组患者在一般资料方面差异无统计学意义(P0.05)。(2)研究结果显示:?观察组术后各时间点VAS评分均低于对照组,差异有统计学意义(P0.05)。?术后3d患者镇痛的满意度各项目评分,观察组均高于对照组,差异有统计学意义(P0.05)。?S-AI状态焦虑量表评分中,观察组和对照组在术前的S-AI评分,差异无统计学意义(P0.05)。而两组在术后36h的焦虑评分,差异有统计学意义(P0.05)。对照组在术前和术后36h的焦虑评分,差异无统计学意义(P0.05)。观察组术后36h的评分低于术前,差异有统计学意义(P0.05)。(4)观察组的首次功能锻炼时间和住院时间均早于对照组,差异有统计学意义(P0.05)。(5)观察组不良反应发生5例(16.67%),对照组不良反应发生10例(33.33%),两组之间差异有统计学意义(P0.05)。结论:以护士为主体的MMA应用于脊柱侧弯患者围手术期,可以有效缓解术后疼痛,提升患者满意度,优化医护服务质量;能够减轻患者的焦虑情况及心理压力;缩短住院时间,加快康复锻炼,降低不良反应发生,促进患者快优康复。
[Abstract]:Objective: to observe the effect of multi-mode analgesia (MMA) with nurses as the main body in the perioperative period of scoliosis, and to explore the applicability of multi-mode analgesia in perioperative period of scoliosis. The purpose of this study was to provide scientific guidance and evidence-based basis for nursing care, to alleviate patients' pain, to provide quality nursing services, and to explore the role and significance of nurses in pain management system. Objects and methods: the method of experimental study was adopted. Sixty patients with scoliosis who were scheduled to perform osteotomy and orthopedic surgery in a hospital from June to July 2017 were selected as the study object. 30 patients with scoliosis were selected as the control group and 30 patients as the observation group from June 10 to July 2017.2. The control group was treated with routine on demand analgesia, while the observation group was treated with MMA with nurses as the main body. The pain scores of the two groups at different time points were compared. The scores of S-AI state anxiety scale, analgesic satisfaction, postoperative recovery and the occurrence of adverse opioid drug reactions were compared between the two groups. To observe the effect of MMA with nurses as the main body in the perioperative period of scoliosis. SPSS software was used to test the data with t test and ANOVA 17) test. The test level was 0. 05, and the difference was statistically significant (P 0. 05). Results the general situation of the subjects: there were 13 males and 17 females, aged 6-21 years, with an average age of 14.63 卤3.36 years in the observation group, and 11 males and 19 females in the control group, aged 8-19 years, with an average age of 15.07 卤2.15 years. There was no significant difference in general data between the two groups. The VAS score of the observation group was lower than that of the control group at all time points after operation, and the difference was statistically significant (P 0.05). The scores of patients' analgesic satisfaction were higher in the observation group than in the control group on the 3rd day after operation. The difference was statistically significant (P 0.05). There was no significant difference between the observation group and the control group in the preoperative S-AI score (P 0.05). There was significant difference in anxiety score between the two groups at 36 hours after operation (P 0.05). There was no significant difference in anxiety score between preoperative and postoperative 36 hours in the control group (P 0.05). The scores of 36 hours after operation in the observation group were lower than those in the preoperative group, the difference was statistically significant (P < 0.05) the first time of functional exercise and the time of hospitalization in the observation group were earlier than those in the control group. The difference was statistically significant (P 0.05).) there were 5 cases of adverse reactions in the observation group and 10 cases in the control group. The difference between the two groups was statistically significant (P 0.05). Conclusion: the application of MMA with nurses as the main body in the perioperative period of scoliosis can effectively relieve postoperative pain, improve the satisfaction of patients, optimize the quality of medical care, relieve anxiety and psychological pressure of patients, shorten the length of stay in hospital. Speed up rehabilitation exercise, reduce the occurrence of adverse reactions, and promote the rapid rehabilitation of patients.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.6

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