摘要
目的探究以护士为基础、麻醉医生为督导的急性疼痛服务模式(nurse–based,anesthesiologist–supervised acute pain service,NBAS–APS)在肩袖损伤修补术患者围手术期的应用效果。方法选取2020年1月至2021年1月于杭州市第三人民医院接受肩袖损伤修补术治疗的94例患者为研究对象,根据随机数字表法将其分为观察组和对照组,每组各47例。对照组患者接受围手术期常规疼痛管理,观察组患者接受NBAS–APS疼痛管理。比较两组患者的术后72h内镇痛效果、术后恢复情况、肩关节功能及生活质量。结果观察组患者的视觉模拟评分法(visual analogue scale,VAS)评分均值(VAS_(mean))、VAS评分最大值(VAS_(max))均显著低于对照组(P<0.05),VAS_(max)持续时间(T_(max))、VAS评分≥3分持续时间(PVAS≥3)、住院时间、肩部功能恢复时间均显著短于对照组(P<0.05)。两组患者的并发症总发生率比较差异无统计学意义(P>0.05)。术后3个月,观察组患者Constant–Murley肩关节功能评分量表的疼痛、功能活动、肩关节活动度和肌力评分均显著高于对照组(P<0.05),健康调查量表36的躯体疼痛、总体健康、生命活力和精神健康评分均显著高于对照组(P<0.05)。结论基于NBAS–APS的疼痛管理模式可有效缓解肩袖损伤修补术患者术后72h内疼痛程度,促进肩关节功能恢复,提高生活质量。
Objective To investigate the application effect of nurse–based,anesthesiologist–supervised acute pain service(NBAS–APS)model in perioperative period of patients undergoing repair of rotator cuff injury.Methods A total of 94 patients who underwent repair of rotator cuff injury in the Third People’s Hospital of Hangzhou from January 2020 to January 2021 were selected as the research subjects,and divided into observation group(n=47)and control group(n=47)by random number table method.The control group received routine pain management in perioperative period,and the observation group received NBAS–APS mode of pain management.The analgesic effect within 72h after operation,postoperative recovery,shoulder function and quality of life were compared between the groups.Results The VAS_(mean) score and VAS_(max) score of observation group were lower than those of control group(P<0.05),the T_(max),duration of PVAS≥3,hospital stay and shoulder function recovery time in observation group were shorter than those in control group(P<0.05).The total incidence of complications showed no significant difference between the groups(P>0.05).Three months after operation,the scores for pain,functional activity,shoulder range of motion and muscle strength in the Constant–Murley shoulder assessment scale,the scores for physical pain,general health,vitality and mental health in 36–item short form health survey of observation group were higher than those of control group(P<0.05).Conclusion Pain management based on the NBAS–APS model can effectively relieve pain of patients within 72h after repair of rotator cuff injury,promote shoulder function recovery,and improve quality of life.
作者
庄列萍
吴群
杜忠举
ZHUANG Lieping;WU Qun;DU Zhongju(Department of Osteology,the Third People’s Hospital of Hangzhou,Hangzhou 310009,China;Department of Pain,the Third People’s Hospital of Hangzhou,Hangzhou 310009,China)
出处
《中国现代医生》
2022年第31期99-103,共5页
China Modern Doctor
基金
浙江省医药卫生科技计划项目(2021KY251)
杭州市科技发展计划项目(20181228Y07)。
