基于动态评估的择时给药在鼻内窥镜术后患者中的应用  

Application of Time-choosing Administration based on dynamic assessment of pain in patients after nasal endoscopic surgery

作　　者：万文锦[1] 黎娜[1] 王苹 张卉[1] 袁慧 WAN Wenjin;LI Na;WANG Ping;ZHANG Hui;YUAN Hui(Department of Otolaryngology,the First Affiliated Hospital with Nanjing Medical University,Nanjing 210029,China;Department of Surgery,the First Affiliated Hospital with Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院耳鼻咽喉科,江苏南京210029 [2]南京医科大学第一附属医院大外科,江苏南京210029

出　　处：《医药高职教育与现代护理》2020年第5期377-380,共4页Medical Higher Vocational Education and Modern Nursing

基　　金：吴阶平医学基金临床科研基金(320.6750.18273)。

摘　　要：目的研究鼻内窥镜手术后患者疼痛动态评估的结果及择时给药在鼻内窥镜手术后疼痛控制中的应用效果。方法选取2018年4月在南京医科大学第一附属医院耳鼻咽喉科行鼻内窥镜手术的患者32例,动态监测患者的疼痛情况,分析患者疼痛特点,拟定择时给药方案。选取2018年5月至2019年1月在南京医科大学第一附属医院耳鼻咽喉科行鼻内窥镜手术的患者97例,根据随机数字表分为对照组与观察组,对照组给予每天两次(8∶00和16∶00)静脉镇痛给药,观察组根据择时给药方案于术后第1天9∶00和21∶00、术后第2天9∶00和抽取鼻腔填塞前30 min择时给予静脉镇痛给药。比较两组患者疼痛强度、睡眠质量和疼痛控制满意率。结果鼻内窥镜手术后患者疼痛呈现持续性和抛物线趋势,具体表现为术后第1天疼痛最为明显,术后第2天疼痛趋缓,抽取鼻腔填塞时疼痛加剧的特点;实施择时给药方案的观察组术后第1天、术后第2天的疼痛评分均值及术后痛感峰值均显著低于对照组(P<0.05);术后第1~3天的睡眠质量均显著优于对照组(P<0.05);疼痛控制满意率高于对照组(P<0.05)。结论对鼻内窥镜术后患者进行基于动态评估的择时镇痛给药方案,有助于患者疼痛管理和促进患者身心恢复,值得临床推广。Objective To study the effects of Time-choosing Administration based on dynamic assessment on pain control for the patients after nasal endoscopic surgery.Methods Thirty-two patients who underwent nasal endoscopic surgery in April 2018 were enrolled.According to dynamic assessment results of patients after nasal endoscopic surgery,the characteristics of their pain were analyzed.Then 97 patients who received the nasal endoscopic surgery from May 2018 to January 2019 were divided into control group and observation group.The patients in control group received intravenous analgesia twice daily.According to Time-choosing Administration,patients in observation group received intravenous analgesia at 9∶00 and 21∶00 on postoperative day,9∶00 on the second day after operation and 30 minutes before extraction of nasal packing.Intensity of pain,sleep quality and satisfaction on pain control were compared between the two groups.ResultsThe pain characteristic showed a continuous and parabolic trend,which was manifested as the most obvious pain on postoperative day and eased on the second day.While the breakout of the pain occurred after nasal packing being taken out.After the implementation of Time-choosing Administration,the intensity of pain decreased,sleep quality and satisfaction with pain improved in observation group(P<0.05).Conclusions Time-choosing Administration based on dynamic assessment of pain in patients after nasal endoscopic surgery is helpful for pain management and recovery of patients,which is worthy of clinical promotion.

关 键 词：鼻内窥镜手术 疼痛 动态评估 择时给药 护理 

分 类 号：R47[医药卫生—护理学]