基于加速康复外科理念的微信交互式宣教在腹腔镜下全子宫切除术后自控静脉镇痛患者中的应用  

Application of WeChat interactive education based on the concept of accelerated rehabilitation surgery in patient-controlled intravenous analgesia after laparoscopic hysterectomy

作　　者：王秋菊[1] 马涛洪[1] 朱潇玲 刘继芳 王亚莉 Wang Qiuju;Ma Taohong;Zhu Xiaoling;Liu Jifang;Wang Yali(Department of Anesthesiology,First Hospital of Shanxi Medical University,Taiyuan 030001,China;The First Afiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China)

机构地区：[1]山西医科大学第一医院麻醉科,太原030001 [2]西安交通大学第一附属医院,西安710061

出　　处：《国际护理学杂志》2024年第21期3984-3988,共5页international journal of nursing

摘　　要：目的探讨基于加速康复外科(ERAS)理念的微信交互式宣教在腹腔镜下全子宫切除术后患者自控静脉镇痛(PCIA)中的应用效果。方法将山西医科大学第一医院2023年3~4月腹腔镜下全子宫切除术后行PCIA的96例患者设为对照组,采用病房护士常规镇痛宣教;2023年5~6月腹腔镜下全子宫切除术后行PCIA的96例患者设为试验组,在病房护士常规宣教基础上进行基于ERAS理念的微信交互式麻醉科护士镇痛宣教,宣教内容及方案经科学论证后制定。比较两组患者的镇痛知识掌握情况、镇痛宣教满意度、术后疼痛评分、PCIA并发症发生率、PCIA泵停机率、残余药量。结果宣教后试验组患者镇痛知识得分和镇痛宣教满意度分别为17(12,20)、18(17,19)分,高于对照组的14(9,17)、15(13,15)分,差异有统计学意义(Z=-9.580、-10.111,均P<0.05)。试验组术后静息和活动疼痛评分分别为(1.56±0.96)、(1.98±1.03)分,低于对照组的(1.85±1.01)、(2.36±1.19)分,差异有统计学意义(t=2.045、2.405,均P<0.05)。两组PCIA并发症发生率比较差异无统计学意义(P>0.05)。试验组PCIA泵停机率为5.21%(5/96),低于对照组的20.83%(20/96),差异有统计学意义(χ2=10.347,P<0.05)。试验组残余药量为24(19,25)ml,低于对照组的32(26,38)ml,差异有统计学意义(Z=-7.208,P<0.05)。结论麻醉科护士于腹腔镜下全子宫切除术后进行基于ERAS理念的微信交互式镇痛宣教可提高PCIA的镇痛知识掌握水平和宣教满意度,改善术后镇痛效果,提高PCIA泵的使用效率。Objective:To explore the application effect of WeChat interactive education based on the concept of enhanced recovery after surgery(ERAS)in patient-controlled intravenous analgesia(PCIA)after laparoscopic hysterectomy.Methods:A total of 96 patients who underwent PCIA after laparoscopic total hysterectomy in the First Hospital of Shanxi Medical University from March to April 2023 were set as the control group,and routine analgesia education was given by ward nurses.A total of 96 patients who underwent PCIA after laparoscopic total hysterectomy from May to June 2023 were selected as the experimental group.WeChat interactive analgesic education for anesthesiology nurses based on the concept of ERAS was conducted on the basis of routine education by nurses in wards.The content and scheme of the education were formulated after scientific demonstration.The mastery of analgesia knowledge,satisfaction of analgesia education,postoperative pain score,incidence of PCIA complications,PCIA pump shutdown rate and residual drug dosage were compared between the two groups.Results:The scores of analgesia knowledge and the satisfaction of analgesia education in the experimental group were 17(12,20)and 18(17,19)points,respectively,which were higher than those in the control group[14(9,17)and 15(13,15)points],and the differences were statistically significant(Z=-9.580,-10.111,P<0.05).The scores of rest and activity pain in the experimental group were(1.56±0.96)points and(1.98±1.03)points,respectively,which were lower than those in the control group[(1.85±1.01)points and(2.36±1.19)points],and the differences were statistically significant(t=2.045,2.405,P<0.05).There was no significant difference in the incidence of PCIA complications between the two groups(P>0.05).The shutdown rate of PCIA pump in the experimental group was 5.21%(5/96),which was lower than that in the control group[20.83%(20/96)],and the difference was statistically significant(χ2=10.347,P<0.05).The residual dosage in the experimental group was 24(19,25)ml,which

关 键 词：加速康复外科 患者自控静脉镇痛 宣教 

分 类 号：R473.6[医药卫生—护理学]