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中国癌症防治杂志

中国癌症防治杂志 ›› 2019, Vol. 11 ›› Issue (3): 262-266.doi: 10.3969/j.issn.1674-5671.2019.03.15

• 护理研讨 • 上一篇    下一篇

多学科协作的个性化镇痛在食管癌根治术后的应用

  

  1. 复旦大学附属中山医院胸外科
  • 出版日期:2019-06-25 发布日期:2019-07-26
  • 通讯作者: 赵慧华。E-mail：shaomingyi1995@hotmail.com
  • 基金资助:
    吴阶平医学基金会临床科研专项资助基金（320.6750.17522）

Application of individualized analgesia with multi-disciplinary collaborative in invasive radical resection of esophageal cancer

  • Online:2019-06-25 Published:2019-07-26

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摘要：  目的  探讨多学科协作的个性化镇痛管理模式在食管癌根治术后患者中的应用效果。 方法 选择2017年9月—2018年3月在我院行食管癌根治术的50例患者为对照组，2018年4月—9月的48例患者为观察组。对照组采用传统镇痛模式，观察组采用多学科协作的个性化镇痛管理模式。比较两组患者的静息痛和活动痛评分、术后首次活动时间、患者自控镇痛（patient-controlled analgesia，PCA）按压次数、止痛泵的停泵率和续泵率及不良反应发生率。结果 观察组患者术后初次静息痛评分、静息痛评分均值、静息痛评分最大值和初次活动痛评分值与对照组比较，差异无统计学意义（P＞0.05），但活动痛评分均值及最大值均小于对照组，且差异均有统计学意义（P<0.05）。在止痛泵使用期间，观察组患者的PCA按压总次数、每日PCA按压次数及止痛泵的续泵率均大于对照组，且差异均有统计学意义（P<0.001），但两组患者的止痛泵停泵率无明显差异（P＞0.05）。观察组患者术后首次下床活动时间小于对照组，差异有统计学意义（P<0.05），但两组患者的不良反应发生率无明显差异（P＞0.05）。结论 多学科协作的个性化镇痛管理模式能提高患者镇痛治疗依从性，且有效控制活动性疼痛，加速康复。

关键词: 食管癌, 多学科协作, 个性化, 镇痛管理

Abstract: Objective To explore the effect of individualized analgesia management model with multi-disciplinary collaboration in patients with esophageal cancer after radical resection. Methods Totals of 50 patients who underwent radical resection of esophageal cancer in our hospotal from September 2017 to March 2018 were selected as the control group，and 48 patients from April to September 2018 were selected as the observation group.The traditional analgesic model was used in the control group，while the individualized analgesia management mode of multi-disciplinary cooperation was adopted in the observation group.The rest pain and activity pain score，the first activity time after operation，the number of patient-controlled analgnesia（PCA） pressing，the pump pause rate，the pump renewing rate and the incidence of adverse reactions were compared between the two groups. Results There were no significant difference in the first rest pain score, the mean rest pain score，the maximum rest pain score and the first activity pain score between the two groups（P＞0.05）. However, the mean value and the maximum value of active pain score in the observation group were significantly lower than the control group （P<0.05）. During the use of PCA, the total numbers of PCA pressing，daily PCA pressing and pump renewing rate in the observation group were significantly higher than those in the control group（P<0.001）. However, there was no significant difference in the pump pause rate between the two groups（P>0.05）. The ambulation time of getting out of bed in the observation group was significantly earlier than that in the control group（P<0.05），but there was no significant difference in the incidence of adverse reactions between the two groups（P>0.05）.  Conclusion The individualized analgesia management model with multi-disciplinary collaboration can improve the compliance of patients with analgesic treatment，and effectively control active pain and accelerate recovery.

Key words: Esophageal cancer, Multidisciplinary collaboration, Individualization, Analgesia management

中图分类号: 

  • Ｒ735.1