CAJ | 학술논문

目的：探讨个案管理对胫骨平台骨折患者疼痛的影响。方法选择2013年1—12月救治的胫骨平台骨折患者60例作为研究对象,均为新发骨折,所有患者均行骨折复位伴钢板内固定术。入选患者按照随机数字对照表法分为观察组和对照组,各30例。对照组接受常规的疼痛治疗与术后护理,观察组在对照组的基础上分步骤实施疼痛个案管理,分别在入院时、术前1 h、术后刚回病室时、术后24,48,72 h评估疼痛程度,及对疼痛的认知情况及疼痛控制满意度。结果护理干预后观察组患者术后24,48,72 h疼痛评分分别为(3.21±1.89),(2.85±1.85),(1.85±1.78)分,明显低于对照组的(4.42±2.15),(3.88±2.03),(2.67±2.31)分,差异有统计学意义(t值分别为3.265,2.896,2.798；P<0.05)；观察组患者术后对疼痛的认知情况明显提高,差异有统计学意义(P<0.05)；观察组患者对疼痛控制满意度PRI 中感觉项与情感项的总分、VAS 评分及 PPI 评分分别为(14.68± 3.24),(4.69±1.57),(4.62±3.28),(1.69±0.87)分,明显优于对照组的(22.43±5.36),(8.45±2.54),(6.49±2.65),(3.66±1.25)分,差异有统计学意义(t值分别为8.365,6.154,5.126,7.458；P<0.01)。结论个案管理护理干预能明显降低胫骨平台骨折患者的疼痛程度,提高患者对疼痛的认知度,提升患者对疼痛控制的满意度。
목적：탐토개안관리대경골평태골절환자동통적영향。방법선택2013년1—12월구치적경골평태골절환자60례작위연구대상,균위신발골절,소유환자균행골절복위반강판내고정술。입선환자안조수궤수자대조표법분위관찰조화대조조,각30례。대조조접수상규적동통치료여술후호리,관찰조재대조조적기출상분보취실시동통개안관리,분별재입원시、술전1 h、술후강회병실시、술후24,48,72 h평고동통정도,급대동통적인지정황급동통공제만의도。결과호리간예후관찰조환자술후24,48,72 h동통평분분별위(3.21±1.89),(2.85±1.85),(1.85±1.78)분,명현저우대조조적(4.42±2.15),(3.88±2.03),(2.67±2.31)분,차이유통계학의의(t치분별위3.265,2.896,2.798；P<0.05)；관찰조환자술후대동통적인지정황명현제고,차이유통계학의의(P<0.05)；관찰조환자대동통공제만의도PRI 중감각항여정감항적총분、VAS 평분급 PPI 평분분별위(14.68± 3.24),(4.69±1.57),(4.62±3.28),(1.69±0.87)분,명현우우대조조적(22.43±5.36),(8.45±2.54),(6.49±2.65),(3.66±1.25)분,차이유통계학의의(t치분별위8.365,6.154,5.126,7.458；P<0.01)。결론개안관리호리간예능명현강저경골평태골절환자적동통정도,제고환자대동통적인지도,제승환자대동통공제적만의도。
Objective To discuss the case management of pain in patients with tibial plateau fractures. Methods Chose a total of 60 patients with fracture of tibial plateau during January to December 2013 in our hospital as the research objects, all patients had fresh fractures and accepted fracture reduction with plate fixation. According to random number table method, selected patients divided into observation group and control group, 30 cases each of group. Pain in the control group accepted routine treatment and postoperative nursing, while patients of the observation group underwent step-by-step implementation of case management based on the the intervention of control group:assessed the level of pain, patient′s perception of pain and satisfaction of pain control when patients admitted, 1 h before operation, came back unit, 24 h, 48 h, 72 h after operation. Results After nursing intervention, the score of pain assessment were (3. 21 ± 1. 89), (2. 85 ± 1. 85), (1. 85 ± 1. 78) in the observation group apparently lower than (4. 42 ± 2. 15), (3. 88 ± 2. 03), (2. 67 ± 2. 31) of control group (t=3. 265, 2. 896, 2. 798; P<0. 05); the recognition of pain among patients of observation group improved dramatically (P<0. 05); in the observation group, the patients acquired (14. 68 ± 3. 24), (4. 69 ± 1. 57), (4. 62 ± 3. 28), (1. 69 ± 0. 87) for the total sensation and affection scores of pain control, VAS score and PPI score better than (22. 43 ± 5. 36), (8. 45 ± 2. 54), (6. 49 ± 2. 65), (3. 66 ± 1. 25) of control group (t =8. 365, 6. 154, 5. 126, 7. 458; P <0. 01). Conclusions Case management nursing intervention can significantly reduce the level of pain in patients with fracture of tibial plateau, increase awareness of pain and patient′s satisfaction to pain control.