基于加速康复外科理念的多模式镇痛在胸外科手术患者中的应用成效  

Effectiveness of Multimodal Analgesia Based on the Concept of Enhanced Recovery afer Surgery in Thoracic Surgery Patients

作　　者：赵欢喆 李宽 陈秋玲 陈娟 彭玲玲 沈楠 ZHAO Huanzhe;LI Kuan;CHEN Qiuling;CHEN Juan;PENG Lingling;SHEN Nan(Department of Pharmacy,Shenzhen People’s Hospital(The Second Clinical Medical College,Jinan University,The First Affiliated Hospital,Southern University of Science and Technology),Shenzhen,Guangdong 518020,China;Department of Pharmacy,Jiangyin People’s Hospital,Jiangyin,Jiangsu 214400,China)

机构地区：[1]深圳市人民医院(暨南大学第二临床医学院,南方科技大学第一附属医院)药学部,广东深圳518020 [2]江阴市人民医院药学部,江苏江阴214400

出　　处：《中国医药指南》2025年第1期28-31,共4页Guide of China Medicine

基　　金：深圳市医学重点学科建设经费资助项目(SZXK059);无锡市科技发展医疗卫生指导性计划项目(NZ2019047)。

摘　　要：目的基于加速康复外科(ERAS)理念制订多模式镇痛方案,探讨其在胸外科手术患者中的应用成效。方法回顾性分析2019年9月至2021年12月深圳市人民医院胸外科手术患者的临床资料,将执行多模式镇痛方案的208例设为多模式组,未实施的119例设为对照组,对比两组的术后镇痛效果、不合理用药率、不良事件发生率、费用。结果多模式组的术后24 h镇痛效果优于对照组(P<0.05)。多模式组两种以上非甾体类抗炎药物(NSAIDs)联用、司琼类重复用药、使用阿片类外用贴剂少于对照组(P<0.05)。两组的恶心、呕吐、头晕发生率差异无统计学意义(P>0.05)。多模式组的药品经济性优于对照组(P<0.05)。结论MDT团队基于ERAS制订的多模式镇痛方案可以降低术后疼痛评分和药品费用,提高用药合理率,保障患者用药的安全性和经济性。Objective To develop a multimodal analgesic program based on the concept of enhanced recovery afer surgery(ERAS)and to explore its application effectiveness in patients undergoing thoracic surgery.Methods Clinical data of patients undergoing thoracic surgery at Shenzhen People's Hospital from September 2019 to December 2021 were retrospectively analyzed.208 patients who underwent multimodal analgesic regimen were assigned to the multimodal group,while 119 patients who did not undergo the regimen were assigned to the control group.The postoperative analgesic effect,irrational drug use rate,incidence of adverse events,and cost were analyzed and evaluated.Results The 24 hours postoperative analgesia effect of the multi-mode group was better than that of the control group(P<0.05).The combined use of two or more nonsteroidal anti-inflammatory drugs(NSAIDs),the repeated use of seetron and use of opioid topical patch in multi-mode group was less than that in control group(P<0.05).There was no significant difference in the incidence of nausea,vomiting and dizziness between the two groups(P>0.05).The drug economy of multi-mode group was better than that of control group(P<0.05).Conclusions The multimodal analgesic plan developed by the MDT team based on ERAS can reduce postoperative pain scores and drug costs,improve medication rationality,and ensure the safety and economy of patient medication.

关 键 词：多模式镇痛 加速康复外科 胸外科 合理用药 多学科 

分 类 号：R655[医药卫生—外科学]