摘要
目的评价智能化PCA管理对患者术后镇痛质量的影响。方法选择智能化PCA系统数据库内2015年1月1日至2017年12月31日期间进行术后PCA的6601例患者,为智能化PEA管理组(Ⅰ组),再根据年份分为3个亚组:2015年亚组(n=2221)、2016年亚组(n=2152)及2017年亚组(n=2228)。选择广东省12家三甲医院2016年4月11日至2016年4月22日期间关于术后镇痛情况多中心调研问卷中由麻醉科主管实施PCA的1235例患者为传统PCA管理组(C组)。记录术后第1和2天静态和动态中度疼痛、重度疼痛、恶心呕吐、过度镇静的发生情况以及患者满意情况。结果与C组比较,Ⅰ组术后各时点静态和动态中度疼痛、重度疼痛、过度镇静和恶心呕吐发生率降低,患者满意率升高(P<0.05或0.01)。与2015年亚组比较,2016年亚组及2017年亚组静态中度疼痛、重度疼痛和动态重度疼痛发生率降低(P<0.05或0.01),2017年亚组恶心呕吐发生率升高(P<0.05);与2016年亚组比较,2017年亚组恶心呕吐发生率升高(P<0.05)。结论智能化PCA管理可改善PEA效果,减少不良反应发生,提高术后镇痛质量。
Objective To evaluate the effect of intelligentized patient-controlled analgesia (PCA) management on the quality of postoperative analgesia in the patients.Methods A total of 6601 patients who underwent postoperative PCA from January 1,2015 to December 31,2017 searched from the intelligentized PCA system database were selected as intelligentized PCA management group (Ⅰ group),and then were divided into 3subgroups according to the year:2015 subgroup (n =2221),2016 subgroup (n =2152) and 2017 subgroup (n=2228).A total of 1235 patients who underwent PCA which was mainly performed by a department of anesthesiology in the postoperative analgesia-related multi-center questionnaire from April 11,2016 to April 22,2016 in 12 grade A tertiary hospitals in Guangdong Province were select- ed as the traditional PCA management group (C group).The development of moderate and severe pain, nausea and vomiting,over-sedation at rest and during activity and patient's satisfaction were recorded on 1st and 2nd days after operation.Results Compared with C group,the incidence of moderate and severe pain, nausea and vomiting and over-sedation at rest and during activity was significandy decreased,and the rate of patient's satisfaction was increased at each time point after operation in Ⅰ group (P<0.05 or 0.01).Compared with 2015 subgroup,the incidence of moderate and severe pain at rest and severe pain during activity was significantly decreased in 2016 and 2017 subgroups (P<0.05 or 0.01),and the incidence of nausea and vomiting was significantly increased in 2017 subgroup (P<0.05).Compared with 2016 subgroup,the incidence of nausea and vomiting was significantly increased in 2017 subgroup (P<0.05).Conclusion Intelligentized PCA management can improve the efficacy of PCA,mitigates the occurrence of adverse reactions and raise the quality of postoperative analgesia in the patients.
作者
曹汉忠
黄文起
彭书崚
许立新
王晟
张静
陈烨
陈小红
佘守章
Cao Hanzhong;Huang Wenqi;Peng Shuling;Xu Lixin;Wang Sheng;Zhang Jing;Chen Ye;Chen Xiaohong;She Shouzhang(Department of Anesthesiology,Affiliated Cancer Hospital of Nantong University,Nantong 226361,China;Department of Anesthesiology,First Affiliated Hospital of Zhongshan University,Guangzhou 510080,China;Department of Anesthesiology,SUN YET-SEN Memorial Hospital of Zhongshan University Guangzhou 510120,China;Department of Anesthesiology,Guangzhou First People's Hospital Affiliated to Guangzhou Medical University,Guangzhou 510180,China;Department of Anesthesiology,Guangdong General Hospital,Guangzhou 510080,China)
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2018年第9期1077-1081,共5页
Chinese Journal of Anesthesiology
基金
科学技术部科技型中小企业技术创新基金(11C26213201247).
关键词
镇痛
病人控制
疼痛
手术后
人工智能
Analgesia,patient-controlled
Pain,postoperative
Artificial intelligence
