山东省164家医院术后镇痛管理现状调查分析  

Management of postoperative pain in 164 hospitals in Shandong Province

作　　者：任晓凤[1] 刘冬华[2] 于爱兰[2] 张宗旺[2] 马建中[3] 冯翠翠[2] 类维富[4] 

机构地区：[1]聊城市人民医院7B脊柱外科,252000 [2]聊城市人民医院西区麻醉科,252000 [3]聊城市人民医院手术室,252000 [4]山东大学齐鲁医院麻醉科,济南250000

出　　处：《国际麻醉学与复苏杂志》2016年第6期513-518,共6页International Journal of Anesthesiology and Resuscitation

基　　金：聊城市医学科研课题项目（[2014]29号）

摘　　要：目的 了解山东省164家医院术后镇痛管理现状. 方法 依据急性疼痛管理指南和疼痛质量评估体系拟定调查问卷,调查内容包括医疗机构的性质、规模大小,疼痛管理的组织架构,急性疼痛服务组织（acute pain service,APS）的人员组成、运行模式、疼痛评估的实施和镇痛技术、流程等.采用多阶段分层整群抽样方法对山东省164家医疗机构进行术后镇痛管理现状调查分析. 结果 APS方面：32.9％的医院成立了类似APS的术后疼痛管理组织.疼痛评估方面：58.5％的医院将疼痛作为第5项生命体征进行评估,42.7％的医院对患者的静息痛和活动痛进行评估.自控镇痛技术方面：44.5％的医院采用自控镇痛模式;其中臂丛神经阻滞、腰丛神经阻滞、股神经阻滞镇痛分别为4.9％、1.2％和4.3％.疼痛知识教育方面：52.4％的医院对患者进行疼痛知识宣教,其中术后病房护士宣教占11.0％,APS查房宣教占1.2％. 结论 山东省医疗机构术后镇痛管理欠规范,护士极少参与疼痛管理,疼痛评估和疼痛知识宣教不到位,缺乏先进的镇痛管理技术.建议成立规范的术后疼痛管理组织和管理评估体系,规范术后疼痛管理.Objective To investigate current situation of postoperative pain mamagement in 164 hospitals in Shandong Province.Methods A questionnaire was developed on the basis of guidelines of acute pain and pain quality assessment.The questionnaire was used to obtain information regarding the nature and scale of the medical institution,the structure of pain management organization,the structure of acute pain service （APS）,the model of APS,the implementation of pain assessment,and the analgesic techniques and processes used in clinical practice.A multi-stage stratified and cluster sampling method were employed to investigate the current situation of postoperative pain management in 164 medical institutions in Shandong Province.Results For APS,32.9% of the hospitals established postoperative pain management organizations similar to APS.For pain evaluation,58.5% of the hospitals evaluated pain as the fifth vital sign,and 42.7% of the hospitals evaluated pain at rest and during activity.Furthermore,44.5% of the surveyed hospitals employed patient-controlled analgesia mode,of which hospitals employing brachial plexus block,lumbar plexus block,and femoral nerve block analgesia accounted for 4.9%,1.2%,and 4.3%,respectively.The survey revealed that 52.4% of the hospitals educated patients about pain and pain management,of which patients were postoperatively educated by ward nurses in 11.0% and patients were educated by APS during ward rounds in 1.2%.Conclusions There is a lack of standardized postoperative pain management.The involvement of nurses in pain management is scarce,and the pain assessment and education and application of advanced analgesic management techniques were found to be inadequate in medical institutions in Shandong Province.Proposed Establish specification evaluation system and postoperative pain management in order to improve the postoperative pain management.

关 键 词：医疗机构 疼痛管理 急性疼痛服务组织 

分 类 号：R614[医药卫生—麻醉学] R197.32[医药卫生—外科学]