西藏自治区人民医院与中国东部13家医院术后急性疼痛现状的比较  

Comparison of acute postoperative pain between Tibet Autonomous Region People’s Hospital and thirteen hospitals in Eastern China

作　　者：姜柏林[1] 朱丽娇 次仁德吉[2] 杨青梅 李艺 冯艺[1] 拉巴次仁[2] JIANG Bailin;ZHU Lijiao;CIREN Deji;YANG Qingmei;LI Yi;FENG Yi;LABA Ciren(Department of Anesthesiology,Peking University People's Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院麻醉科,100044 [2]西藏自治区人民医院麻醉科

出　　处：《临床麻醉学杂志》2022年第12期1302-1306,共5页Journal of Clinical Anesthesiology

摘　　要：目的比较西藏自治区人民医院与中国东部13家医院术后急性疼痛的现状。方法通过国际围术期疼痛注册登记及研究网络(PAIN OUT)提供的标准方法,收集2021年10月至2022年8月西藏自治区人民医院手术患者的术后急性疼痛信息,并与中国东部13家医院的患者数据比较,采用标准化均数差(Hedge’s g)比较临床差异。采用Logistic回归校正差异,比较两个地区术后急性疼痛发生的差异。结果西藏自治区人民医院和中国东部13家医院分别有262例和1865例患者被纳入分析。与中国东部13家医院比较,西藏自治区人民医院围术期使用局麻镇痛技术比例[21.4%vs 55.2%,g=-0.83(95%CI-1.00~-0.66)]、术中使用非阿片类药物比例[6.9%vs 70.8%,g=-1.92(95%CI-2.19~-1.65)]、术后使用阿片类药物比例[1.9%vs 29.9%,g=-1.70(95%CI-2.19~-1.21)]以及疼痛体验评分[2.54(1.65~3.66)vs 0.74(0.37~1.37),g=2.28(95%CI 2.14~2.43)]明显降低,术后经历急性中重度疼痛的比例明显升高[80.5%vs 56.5%,g=0.64(95%CI 0.46~0.81)]。结论与中国东部13家医院比较,西藏自治区人民医院患者的术后急性疼痛更明显,疼痛管理存在较大改进空间。Objective To compare the current situation of acute postoperative pain between Tibet Autonomous Region People’s Hospital and thirteen hospitals in Eastern China.Methods A standardized methodology provided by the international quality improvement and perioperative pain registry project,PAIN OUT,was used to assess postoperative pain information of patients in Tibet Autonomous Region People’s Hospital from October 2021 to August 2022.A dataset specific to patients in thirteen hospitals in Eastern China was compared with the dataset of Tibet.Clinically significant differences were inferred from effect size(Hedge’s g).The influence of region on moderate to severe pain was adjusted by logistic regression.ResultsA total of 262 patients at Tibet Autonomous Region People’s Hospital and 1865 patients in the thirteen hospitals in Eastern China were analyzed.Compared with the hospitals in Eastern China,perioperative use of regional anesthetic techniques[21.4%vs 55.2%,g=-0.83(95%CI-1.00 to-0.66)],intraoperative administration of nonopioid drugs[6.9%vs 70.8%,g=-1.92(95%CI-2.19 to-1.65)],and postoperative administration of opioid drugs[1.9%vs 29.9%,g=-1.70(95%CI-2.19 to-1.21)],and the score of pain experience of patients[2.54(95%CI 1.65 to 3.66)vs 0.74(95%CI 0.37 to 1.37),g=2.28(95%CI 2.14 to 2.43)]were significantly decreased in Tibet,whereas the ratio of the patients who reported moderate or severe pain was significanthy increased[80.5%vs 56.5%,g=0.64(95%CI 0.46 to 0.81)]in Tibet.Conclusion Compared with the hospitals in Eastern China,the patients of Tibet Autonomous Region People’s Hospital have experienced worse pain experiences.Perioperative pain management in Tibet should be improved given the large differences between the regions.

关 键 词：术后急性疼痛 疼痛管理 阿片类药物 高海拔 PAIN OUT项目 

分 类 号：R614[医药卫生—麻醉学]