脊柱外科病人围手术期超前镇痛方案的疼痛护理要点
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【摘要】目的：分析脊柱外科病人围手术期超前镇痛方案的疼痛护理要点。方法：对2010年1月～2010年6月期间310例脊柱外科住院病人，根据面部疼痛表情量表(FPS-R)评分制定规范化、个体化、多模式的超前镇痛方案，并采取加强教育、提高护士技能、合理与规范使用止痛药等疼痛护理措施。结果：95%患者止痛效果满意，术后第4日FPS-R平均评分为3.5，较术前与术后第1日平均评分均明显改善(P<0.05)。15.2%患者术后需联合应用阿片类药物，其中8%患者只需使用1次，未出现与严重疼痛相关或与止痛药物相关的并发症。结论：对脊柱外科围手术期病人采取规范化的疼痛护理管理有助于减轻术后疼痛、提高患者对手术质量的整体评价、尽早开展康复训练及降低术后并发症。
【关键词】脊柱外科；围手术期；超前镇痛；疼痛；护理
The key points of perioperative pain-nursing for patients treated with preemptive analgesia in the department of spine surgery
LUO Chun-xiao, OU Zhao-lan ,.DONG Jian-wen*
( Department of Spine Surgery, the 3rd Affiliated Hospital of Sun Yet-sen University, GuangZhou, 510630, China )
【Abstract】Objective：To analyze the key points of perioperative pain-nursing for patients treated with preemptive analgesia in the department of spine surgery. Methods：310 patients in our department from Jan 2010 to Jun 2010 were treated with standardized, individualized and multi-pattern preemptive analgesia based on FPS-R score system, as well as series of pain-nursing program including education for both nurses and patients, re-recognition of narcotic analgesics and NSIADs, improving the skill to accurately evaluate pain, reasonable and standardized utilization of analgesics. Results：The pain was relieved satisfactorily in 95% patients. According to FPS-R system, the average pain score of 3.5 on the 4th day postoperatively was obviously improved compared to that preoperatively and on the 1st day postoperatively. 15.2% patients needed analgesia combined with opioid and 8% of them only needed once usage. There was no complication related to severe pain and analgesics.Conclusions：Standardized perioperative pain-nursing and management for the patients in the department of spine surgery can contribute to reduce postoperative pain, to improve the global assessment of the quality of spine surgery by the patients, to carry out early rehabilitation training, and to reduce the rate of postoperative complications.
【Key words】spine surgery, perioperative, preemptive analgesia, pain, nursing
疼痛是绝大多数脊柱外科疾病的共有特征与首发症状，也是脊柱外科手术之后患者需要面临与担心的主要问题，因此，围手术期疼痛管理越来越受到重视 ......
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