国际护理学杂志
國際護理學雜誌
국제호이학잡지
INTERNATIONAL JOURNAL OF NURSING
2008年
12期
1290-1292
,共3页
腹部手术%病人自控%硬膜外麻醉%镇痛%护理评价
腹部手術%病人自控%硬膜外痳醉%鎮痛%護理評價
복부수술%병인자공%경막외마취%진통%호리평개
Abdominal operation%Patient control epidural analgesia%Nursing evaluation
目的 对采用自控硬膜外镇痛病人的镇痛镇静效果及心理学变化等进行评价.方法 随机选择施行腹部手术的病人为镇痛组(n=70),采用光达电子泵向硬膜外控连续输注镇痛复合液(0.5%的布比卡因20 ml,芬太尼0.4 mg,昂丹司琼8 mg加生理盐水至100 ml);对未行PCEA的病例列为对照组(n=70),分别于术后2、6、10、16、24 h进行疼痛视觉模拟计分(VAS),Ramsay镇静评分;并于术前、术后24 h进行心理学调查(SAS、SDS)和对BP、HR变化、生活质量进行评估.结果 发现镇痛组VAS<1,Ramsay镇静评分在2.1～3.2之间,SAS、SDS也分别由术前42.5±3.1,42.8±2.2降至术后的40.6±3.2,39.8±3.2(P<0.05),BP、HR相对平稳;生活质量、依从性也相对提高;而对照组的VAS评分4.70,Ramsay镇静评分界于0.89～1.22之间,SAS、SDS由术前的42.5±2.8,42.6±2.2分别增加到44.5±2.7,43.7±2.6(P<0.05);BP升高不明显,HR明显增快,术后自理能力,对医护人员的依从性也相对较差.结论 PCEA术后镇痛、镇静可靠,有利于心理状态、血液动力学稳定和术后康复.
目的 對採用自控硬膜外鎮痛病人的鎮痛鎮靜效果及心理學變化等進行評價.方法 隨機選擇施行腹部手術的病人為鎮痛組(n=70),採用光達電子泵嚮硬膜外控連續輸註鎮痛複閤液(0.5%的佈比卡因20 ml,芬太尼0.4 mg,昂丹司瓊8 mg加生理鹽水至100 ml);對未行PCEA的病例列為對照組(n=70),分彆于術後2、6、10、16、24 h進行疼痛視覺模擬計分(VAS),Ramsay鎮靜評分;併于術前、術後24 h進行心理學調查(SAS、SDS)和對BP、HR變化、生活質量進行評估.結果 髮現鎮痛組VAS<1,Ramsay鎮靜評分在2.1～3.2之間,SAS、SDS也分彆由術前42.5±3.1,42.8±2.2降至術後的40.6±3.2,39.8±3.2(P<0.05),BP、HR相對平穩;生活質量、依從性也相對提高;而對照組的VAS評分4.70,Ramsay鎮靜評分界于0.89～1.22之間,SAS、SDS由術前的42.5±2.8,42.6±2.2分彆增加到44.5±2.7,43.7±2.6(P<0.05);BP升高不明顯,HR明顯增快,術後自理能力,對醫護人員的依從性也相對較差.結論 PCEA術後鎮痛、鎮靜可靠,有利于心理狀態、血液動力學穩定和術後康複.
목적 대채용자공경막외진통병인적진통진정효과급심이학변화등진행평개.방법 수궤선택시행복부수술적병인위진통조(n=70),채용광체전자빙향경막외공련속수주진통복합액(0.5%적포비잡인20 ml,분태니0.4 mg,앙단사경8 mg가생리염수지100 ml);대미행PCEA적병례렬위대조조(n=70),분별우술후2、6、10、16、24 h진행동통시각모의계분(VAS),Ramsay진정평분;병우술전、술후24 h진행심이학조사(SAS、SDS)화대BP、HR변화、생활질량진행평고.결과 발현진통조VAS<1,Ramsay진정평분재2.1～3.2지간,SAS、SDS야분별유술전42.5±3.1,42.8±2.2강지술후적40.6±3.2,39.8±3.2(P<0.05),BP、HR상대평은;생활질량、의종성야상대제고;이대조조적VAS평분4.70,Ramsay진정평분계우0.89～1.22지간,SAS、SDS유술전적42.5±2.8,42.6±2.2분별증가도44.5±2.7,43.7±2.6(P<0.05);BP승고불명현,HR명현증쾌,술후자리능력,대의호인원적의종성야상대교차.결론 PCEA술후진통、진정가고,유리우심리상태、혈액동역학은정화술후강복.
Objective To evaluate the effects of patient control epidural analgesia (PCEA) on analge-sia,sedation.Psychology,HR,BP and life quality in patients after abdominal surgery.Methods Patients were consecutively randomized in to analgesia group (n=70) in which PCEA were used,analgesic solution (0.5% bubivacaine 20 ml,fentany 10.4 mg,ondansetron 8 mg diluted to 100 ml with 0.9% NaCl) were continuously infusion in to epidural Cavity with electronic pump; Those patients without PCEA were control group (n=70),VAS,Ramsay sedation scal and changes of BP,HR were monitor in 2,6,10,16,24 h post operation and SAS.SDS were investigate before operation and 2d after surgery respectively.Simultaneously.The life quality and dependence with nurse were observation by nurses.Results All patients in analgesic group presented the best an-algesic sedation efficacy,VAS scores < 1,Ramsay sedation scale in between 2.1～3.2,SAD (40.6),SDS (39.8) post operation were significantly less than SAD (42.5),SDS (42.8) before operation (P < 0.05),BP,HR were reladve stability at various time points,life quality have been obviously improved; In the control group,VAS scores.Ramsay scale were 4.70,Ramsay sedation scale in between 0.89～1.22,the SAS (44.5),SDS (43.8) of post operation were oberviously increase (P<0.05) than before operation,HR were increased in various time point expertly 2 h post operation and there were severe anxious reaction have been obser-vation,wheares patient life quality dependence were reduction than analgesic group.There were significantly difference (P<0.05) for VAS Ramsay sedation seal and SAS.SDS between two groups compared in various time points after surgery (except 2 h post operation).Conclusion PCEA may be provided effective postoperative an-algesia,reduce psychological reaction,and improve life quality,in which beneficial for patient recovery.
