疼痛管理对急性胰腺炎留观患者住院周期的影响  

Impact of pain management on length of stay for patients with acute pancreatitis in emergency department

作　　者：瞿小英 李卓权[2] QU Xiao-ying;LI Zhuo-quan(Dept.of Emergency,Changhai Hospital,Navy Medical University,Shanghai 200433,China;School of Medicine,Tongji University,Shanghai 200092,China)

机构地区：[1]海军军医大学附属长海医院急诊科,上海200433 [2]同济大学医学院,上海200092

出　　处：《同济大学学报（医学版）》2021年第5期633-637,共5页Journal of Tongji University(Medical Science)

摘　　要：目的研究疼痛管理对急诊留观急性胰腺炎(acute pancreatitis,AP)患者的疼痛发展以及住院周期的影响。方法回顾分析长海医院2018年1月—2019年12月共563名急诊留观住院AP患者的疼痛分级、分类,疼痛处理以及疼痛管理后的住院周期情况。结果AP患者主要症状为腹痛,女性患者平均年龄高于男性(P=0.037)。以MAP分类为主,MAP和MSAP疼痛分级均以2级为主,分类内所占比例分别为59.7%和61.3%。不镇痛患者只有4.6%恶化。1级和2级疼痛MAP患者、2级疼痛MSAP患者镇痛治疗后显著延长住院天数。结论对于MAP患者的1级和2级疼痛,在临床疼痛管理中,尽量不考虑药物镇痛;对于MSAP患者的1级和2级疼痛,应当结合临床情况,鼓励患者减少使用药物镇痛。Objective To study the impact of pain management on length of stay for patients with acute pancreatitis(AP)in emergency department.Methods Clinical data of 563 AP patients admitted in emergency department of Changhai hospital from January 2018 to December 2019 were retrospectively reviewed.The pain score was measured and the impact of pain management on length of stay was analyzed.Results The main symptom of AP patients was abdominal pain and the average age of female patients was higher than that of men(P=0.037).According to AP classification,there were 484 cases of mild acute pancreatitis(MAP,86.0%),62 cases of moderately severe acute pancreatitis(MSAP,11.0%)and 17 cases of severe acute pancreatitis(SAP,3.0%).The pain in most of MAP and MSAP patients was classified as level 2 with a proportion of 59.7%and 61.3%,respectively.Only 4.6%patients without analgesia were deteriorated.MAP patients with level 1 or level 2 pain and MSAP patients with level 2 pain significantly prolonged the length of stay after analgesic treatment.Conclusion To level 1 and level 2 pain in MAP patients drug analgesia may not be considered.Meanwhile MSAP patients with level 1 or level 2 pain are encouraged to reduce the consumption of drug analgesia.Appropriate clinical pain management would be helpful for AP patients to recover and shorten the length of stay.

关 键 词：急性胰腺炎 疼痛管理 疼痛分级 镇痛治疗 住院周期 

分 类 号：R576[医药卫生—消化系统]