前列腺电切术后膀胱痉挛性疼痛管理模式的对比研究  

COMPARISON OF PAIN MANAGEMENT BETWEEN ROUTINE MODE AND PDCA CYCLE ON POSTOPERATIVE CYSTOSPASM PAIN IN PATIENTS AFTER TRANSURETHRAL RESECTION OF THE PROSTATE

作　　者：钱春娅[1] 郑天兰[1] 顾莹[1] 赵敏华[1] 欧阳骏[1] 

机构地区：[1]苏州大学附属第一医院泌尿外科,苏州215006

出　　处：《中国疼痛医学杂志》2014年第12期877-881,共5页Chinese Journal of Pain Medicine

基　　金：国家自然科学基金面上项目资助(编号:81070591)

摘　　要：目的:比较常规疼痛管理和PDCA(策划、实施、检查、处理)循环疼痛管理模式在经尿道前列腺电切除术(TURP)后膀胱痉挛性疼痛中的应用效果。方法:选取我院泌尿外科行TURP的术后患者125例,随机分为PDCA组63例、常规组62例。PDCA组行PDCA循环疼痛管理模式,常规组行常规疼痛管理模式,比较两组患者用药后每12 h痉挛性疼痛的发生次数、每次疼痛的持续时间、疼痛程度、冲洗液转清时间、导尿管拔除时间、术后住院时间以及疼痛管理满意度的情况。结果:PDCA组患者视觉模拟评分(VAS)、膀胱内压、膀胱痉挛性疼痛次数以及每次疼痛的持续时间均优于常规组,P<0.05,差异有统计学意义。PDCA组患者术后镇痛液的使用量、尿转清时间、拔尿管时间、膀胱痉挛性疼痛发生率以及疼痛管理满意度均明显优于常规组,P<0.05,差异有统计学意义;PDCA组术后再出血、呕吐、低血压等少于常规组,但差异无统计学意义,P>0.05。结论:PDCA循环疼痛管理模式较常规疼痛管理模式可显著减少TURP患者术后膀胱痉挛性疼痛的发生次数和每次疼痛的持续时间,降低疼痛程度、缩短冲洗液转清时间和导尿管拔除时间以及有效提高患者对疼痛管理的满意度。Objective： To compare the efficacy of pain management between routine mode and PDCA cycle on postoperative cystospasm pain in patients after transurethral resection of the prostate （TURP）. Methods： 125 patients after TURP were randomly divided into two groups： 63 patients in PDCA group, 62 patients in routine group. The experimental group underwent PDCA cycle of pain management while the control group received routine pain management mode. Results： Compared with the routine group, the VAS score, intravesical pressure, frequency and duration of cystospasm in the PDCA group were significantly better （P 〈 0.05）. Dosage of analgesia liquid, times of urine clear and pulling out urinary catheter, incidence of cystospasm and satisfaction with pain management in the PDCA group were significantly better than those in routine group （P 〈 0.05）.The complications of rehaemorrhagia, vomiting and hypotension in two groups had no significant differences （P 〉 0.05）. Conclusions： The PDCA cycle of pain management on postoperative cystospasm in patients after TURP significantly reduces the cystospasm, intravesical pressure, frequency and duration of cystospasm, the dosage of fentanyl, times of urine clear and pulling out urinary catheter and incidence of cystospasm, improves the satisfaction of patient on the pain management.

关 键 词：PDCA循环 疼痛管理 前列腺电切除术 膀胱痉挛 

分 类 号：R699[医药卫生—泌尿科学]