疼痛规范化管理对人工髋关节置换术患者疼痛结局和髋关节功能的干预研究  

Efficacy of standardized pain management in prognosis of postoperative pain and functional recovery after total hip arthroplasty

作　　者：史凌云[1] 刘媛媛[2] 周月晨 祖力皮也·吐尔逊[4] 曹帆[1] 杨益[4] Shi Lingyun;Liu Yuanyuan;Zhou Yuechen;Zulipiye·Tuerxun;Cao Fan;Yang Yi(Department of Joint Surgery,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China;Disinfection and Distribution Center Secondary Supply Room of the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China;Department of Emergency Surgery,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China;Department of Nursing,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院关节外科,乌鲁木齐830054 [2]新疆医科大学第一附属医院消毒配送中心次供应室,乌鲁木齐830054 [3]新疆医科大学第一附属医院急诊外科,乌鲁木齐830054 [4]新疆医科大学第一附属医院护理部,乌鲁木齐830054

出　　处：《中国实用护理杂志》2020年第30期2331-2337,共7页Chinese Journal of Practical Nursing

基　　金：新疆维吾尔自治区自然科学基金(2016D01C253)。

摘　　要：目的探讨对人工髋关节置换手术患者在术后进行疼痛规范化管理是否有助于其术后疼痛控制和促进髋关节功能的恢复。方法从2018年12月至2019年8月对在新疆医科大学第一附属医院关节外科初次拟行单侧全髋关节置换术的患者为研究对象,获得患者知情同意后,按照纳入和排除标准,最终确定研究对象100例,然后采用随机数字表法将其分为对照组和干预组,每组50例。对照组按常规方法进行疼痛管理,干预组采用自制的髋关节置换术后患者疼痛的规范化管理策略,通过比较2组患者在干预前后其疼痛结局和Harris髋关节功能评分问卷得分情况,来观察疼痛规范化管理的效果。结果在干预前,2组患者在疼痛结局和Harris髋关节功能评分方面的得分比较,差异均无统计学意义(P>0.05),而在实施疼痛规范化管理干预后,干预组患者疼痛结局各项得分均高于对照组,疼痛结局总分干预组(12.23±2.39)分,低于对照组的(14.50±2.18)分,差异有统计学意义(t值为4.962,P<0.001);干预组Harris量表各项得分均高于对照组,干预组总分(73.61±5.06)分,高于对照组的(64.98±7.35)分,且差异有统计学意义(t值为-6.652,P<0.001)。结论对于人工髋关节置换手术术后患者根据情况实施疼痛规范化管理,患者的疼痛结局情况较好,而且有助于促进患者的术后髋关节功能的恢复,从而提高患者对于治疗效果的满意度。Objective To evaluate postoperative pain control and functional recovery of standardized pain management after total hip arthroplasty.Methods A retrospective analysis between December 2018 and August 2019 included 100 patients who underwent unilateral total hip arthroplasty in department of arthroplasty at the First Affiliated Hospital of Xinjiang Medical University.After informed consent were obtained,the 100 subjects were randomly divided into the control group and the study group according to the inclusion and exclusion criteria,which totaled 50 patients in each group.Traditional postoperative pain management was used in control group and a self-made standardized pain management strategy was chosen in the study group.The prognosis of postoperative pain and the Harris Hip Score(HHS)were compared between the two groups.Results Before intervention,there was no statistically significant difference in pain outcomes and HHS(P>0.05).After standardized management of pain,the pain outcome scores of the intervention group were all higher than those of the control group,and the total pain outcome score of the intervention group(12.23±2.39)points was lower than that of the control group(14.50±2.18)points,with statistically significant difference(t value was 4.962,P<0.001).All the Harris scale scores of the intervention group were higher than those of the control group,and the total score of the intervention group(73.61±5.06)was higher than that of the control group(64.98±7.35),with statistically significant differences(t value was-6.652,P<0.001).Conclusion Standardized pain management protocol can be fairly effective in the prognosis of postoperative pain and functional recovery and therefore improve patients′satisfaction after total hip arthroplasty.

关 键 词：疼痛规范化管理 人工髋关节置换术 疼痛结局 

分 类 号：R473.6[医药卫生—护理学]