骨科术后疼痛的原因分析及对策研究

目的:总结骨科术后疼痛的原因,并采取合适对策,以期降低骨科患者疼痛,提高满意度。方法:选取2012年1月-2015年1月1500例骨科手术患者为研究对象,总结引起疼痛的原因,并按照住院号单双号分成2组,对照组给予双氯芬酸钠栓镇痛,观察组采用镇痛泵镇痛,根据麻醉情况选择静脉镇痛或硬膜外镇痛,给予舒芬太尼或地佐辛镇痛,观察两组治疗前后相关指标的变化情况。结果:骨科术后疼痛原因以手术创伤为主,占92.93%,其次是手术体位限制,占53.07%,尿潴留占37.07%。两组治疗后SAS、SDS评分均较治疗前显著下降,差异具有统计学意义(P0.05),观察组治疗后SAS、SDS评分较对照组治疗后改善更加显著(P0.05)。观察组治疗后3 h、10 h、1 d、3 d、7 d VAS评分均较治疗前显著下降(P0.05),对照组治疗后3 d、7 d VAS评分较治疗前显著下降(P0.05),观察组治疗后3 h、10 h、1 d、3 d VAS评分较对照组改善更加显著(P0.05)。结论:骨科术后疼痛原因主要与手术创伤、手术体位限制有关,使用镇痛泵辅以及心理疏导能有效缓解骨科术后患者的对疼痛的感知,改善患者术后的生活质量。

Analysis of the Causes and Countermeasure of the Postoperative Pains for Orthopedic Patients

Objective:To Summarize the causes of postoperative pains of orthopedic patients and take appropriate countermeasures in order to relieve the postoperative pain and improve the satisfaction.Methods:From Jan. 2012 to Jan. 2015, 1500 cases of orthopedic patients with postoperative pains were chosen, the pain causes were summarized. The patients were divided into two groups according into the single and double number, the control group was given diclofenac sodiumsuppositories, while the observation group was given epidural analgesic tube, who were given intravenous analgesia and epidural analgesia according to anesthesia situation and given sufentanil or dezocine. The relevant indicators situation changes before and after treatment in both groups were observed and compared.Results:The main postoperative pains for orthopedic patients were operative wound, which accounted for 92.93%, the second was operative position limitation, which accounted for 53.07%, the uroschesis was 37.07%. Compared with before treatment, the SAS and SDS scores of both groups after treatment were significantly decreased(P<0.05). Compared with the control group, the SAS and SDS scores of observation group were obviously improved(P<0.05). Compared with before treatment, the VAS scores at 3 h, 10 h, 1 d, 3 d and 7 d after treatment of observation group after treatment were obviously decreased than those after treatment (P<0.05). while the VAS scores at 3 d and 7 d after treatment of control group were obviously decreased than those after treatment (P<0.05). Compared with the control group, the VAS scores at 3 h, 10 h, 1 d, 3 d of observation group had obviously improved (P<0.05).Conclusion:The postoperative pains for orthopedic patients were mainly related to the operative wound and operative position limitation, epidural analgesic tube and psychological counseling could effectively release the pain and enhance the patients'' quality of life.