危重症患者疼痛观察工具在肺移植术后患者疼痛评估中的应用效果  

Application effects of COPT on pain assessment after lung transplantation

作　　者：朱亭立[1] 王芳 黄云娟[1] 许正红[1] 蔡英华[3] 黄琴红[2] 

机构地区：[1]南京医科大学附属无锡人民医院护理部,214023 [2]南京医科大学附属无锡人民医院胸外ICU,214023 [3]南京医科大学附属无锡人民医院医管中心,214023

出　　处：《中华现代护理杂志》2016年第9期1249-1252,共4页Chinese Journal of Modern Nursing

基　　金：无锡市科技指导性计划项目（CSZ00N1206）

摘　　要：目的 验证危重症患者疼痛观察工具（CPOT）在评估肺移植术后患者疼痛的有效性.方法 2名重症护理人员应用CPOT量表对42例行肺移植手术后入住ICU的成年患者进行疼痛评估,分为3个评估阶段,每个阶段包括2个测评点（翻身前静息时和翻身刺激时）,共6个测评点（T1-T6）.第1阶段（患者全麻未醒、经口气管插管应用人工呼吸机）,第2阶段（患者神志清楚、经口气管插管应用人工呼吸机）,第3阶段（患者已拔出经口气管插管,呼吸机暂停）.每个观测点的评估时间为1 min,记录患者T1-T6的CPOT值.（第2阶段应用数字评分法）.结果 3个阶段,翻身刺激时测评点的CPOT值均高于翻身前静息测评点;2名重症护理人员CPOT评分一致性较高;第二阶段患者CPOT评分与NRS评分结果 一致性较高.结论 CPOT是能有效的判定肺移植术后机械通气患者疼痛的有效手段.Objective To verify the effects of critical-care pain observation tool （ CPOT） on pain assessment after lung transplantation. Methods 2 critical care nurses applied CPOT scale for pain assessment of 42 cases hospitalized in ICU after lung transplantation who would have pain assessment. The whole investigation were divided into 3 stages and 2 points of each stage （ rest before turning over and the simulation of turning over） with total 6 measuring point （T1-T6）. The first stage was patients with general anesthesia （ no awareness） , the second stage （ patients with sanity and applied artificial respirator through oral trachea cannula, the third stage （ patients got off oral trachea cannula and ventilator paused ） . The measurement point was 1 min, recording patient′s value of CPOT from T1 to T6. The second stage was used digital scoring method. Results For 3 stages, the measurement points of turning over for CPOT value was higher than that of rest measurement point before turning over; 2 critical patients had high uniformity for CPOT score;in stage 2, patient′s CPOT score had high uniformity with NRS score. Conclusions CPOT is a effective way to assess pain for mechanically ventilated patients after lung transplantation.

关 键 词：疼痛 重症监护 肺移植术 危重症患者疼痛观察工具 

分 类 号：R473.6[医药卫生—护理学]