CAJ | 학술논문

目的：观察非药物干预措施对下肢骨科术后硬膜外镇痛效果的影响，评价非药物干预措施在术后镇痛中的临床价值。方法将80例择期下肢骨科手术患者按随机数字表法分为观察组和对照组，每组40例。两组均采用硬膜外麻醉，术后使用自控式镇痛泵。对照组采用常规护理，包括镇痛泵的使用、口腔护理、饮食护理、导管护理、会阴护理、常规宣教及适当体位等。观察组在常规护理的基础上增加以责任护士为主导的一系列非药物干预措施，如加强医护人员疼痛管理教育、患者参与的预期疼痛教育、使用三维立体冰袋、心理干预和音乐干预。观察两组术后48 h内疼痛强度以及不良反应的发生情况及镇痛泵按压总次数。结果观察组在术后4，8，12，24，48 h各时段疼痛强度均低于对照组，差异有统计学意义（P＜0．05）。观察组不良反应总发生率为7．5％，低于对照组的25．0％，差异有统计学意义（χ2＝4．5006，P＜0．05）。观察组的镇痛泵按压次数为（2．2±1．1）次，低于对照组的（3．3±1．2）次，差异有统计学意义（t＝4．2737，P＜0．05）。结论非药物干预措施能有效降低疼痛程度，减少镇痛泵按压次数及不良反应的发生率。
목적：관찰비약물간예조시대하지골과술후경막외진통효과적영향，평개비약물간예조시재술후진통중적림상개치。방법장80례택기하지골과수술환자안수궤수자표법분위관찰조화대조조，매조40례。량조균채용경막외마취，술후사용자공식진통빙。대조조채용상규호리，포괄진통빙적사용、구강호리、음식호리、도관호리、회음호리、상규선교급괄당체위등。관찰조재상규호리적기출상증가이책임호사위주도적일계렬비약물간예조시，여가강의호인원동통관리교육、환자삼여적예기동통교육、사용삼유입체빙대、심리간예화음악간예。관찰량조술후48 h내동통강도이급불량반응적발생정황급진통빙안압총차수。결과관찰조재술후4，8，12，24，48 h각시단동통강도균저우대조조，차이유통계학의의（P＜0．05）。관찰조불량반응총발생솔위7．5％，저우대조조적25．0％，차이유통계학의의（χ2＝4．5006，P＜0．05）。관찰조적진통빙안압차수위（2．2±1．1）차，저우대조조적（3．3±1．2）차，차이유통계학의의（t＝4．2737，P＜0．05）。결론비약물간예조시능유효강저동통정도，감소진통빙안압차수급불량반응적발생솔。
Objective To study the effect of non-medicine intervention on the postoperative patient controlled epidural analgesia of lower limbs orthopedics surgery , and to assess the clinic value of non-medicine intervention .Methods Totals of 80 cases were selected and randomly divided into observation group and control group with 40 cases each group , they received epidural anesthesia and patient controlled analgesia .Patients in control group received the routine nursing such as analgesia using , diet and mouth care , catheter and perineum nursing, routine education and suitable position and so on .On the basis of that, patients in observation group received non-medicine intervention such as enhancing the pain management education of medical staff , education for patient on pain expection , three-dimensional ice packs using , mental and music intervention .Then, the incidence of adverse reaction such as pain degree , dizzy, nausea and spit , itch and so on, and total times of press analgesia during 48 hours after the operation were observed of two groups .Results Pain degree of observation group at 4,8,12,24,48 h after operation respectively were lower than that of control group , the differences were statistically significant (P<0.05).The incidence of adverse reaction such as pain degree , dizzy, nausea and spit, itch of observation group was 7.5%, and that was 25.0% of control group, and the difference was statistically significant (χ2 =4.500 6,P<0.05).As well as the total times of press analgesia in observation group was (2.2 ±1.1) , lower than that in control group (3.3 ±1.2), the difference was statistically significant (t=4.273 7,P<0.01).Conclusions Non-medicine intervention can effectively reduce the pain degree , reduce the times of press analgesia and the incidence of adverse reaction .