發(fā)布時(shí)間：2018-06-04 01:21

  本文選題：多模式鎮(zhèn)痛 + 脊柱側(cè)彎　； 參考：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:觀察以護(hù)士為主體的多模式鎮(zhèn)痛方法(MMA)應(yīng)用于脊柱側(cè)彎患者圍手術(shù)期的效果,探討脊柱側(cè)彎患者圍手術(shù)期的多模式鎮(zhèn)痛方案的適用性,以期為護(hù)理提供科學(xué)性的指導(dǎo)和循證依據(jù),減輕患者疼痛,提供優(yōu)質(zhì)護(hù)理服務(wù),同時(shí)探索護(hù)士在疼痛管理體系中的作用與意義。對(duì)象與方法:采用實(shí)驗(yàn)研究的方法。選取2016.5-2017.2在某院擬行脊柱截骨矯形術(shù)的脊柱側(cè)彎患者60例為研究對(duì)象,2016.5-9的30例患者為對(duì)照組,2016.10-2017.2的30例患者為觀察組。對(duì)照組采用常規(guī)按需鎮(zhèn)痛護(hù)理,觀察組采用以護(hù)士為主體的多模式鎮(zhèn)痛MMA。比較兩組患者不同時(shí)間點(diǎn)的疼痛評(píng)分、S-AI狀態(tài)焦慮量表評(píng)分、鎮(zhèn)痛滿(mǎn)意度、術(shù)后恢復(fù)情況及阿片類(lèi)藥物不良反應(yīng)發(fā)生情況,從而觀察以護(hù)士為主體的MMA應(yīng)用于脊柱側(cè)彎圍手術(shù)期患者的效果。采用SPSS軟件對(duì)數(shù)據(jù)進(jìn)行t檢驗(yàn)、方差分析、c(17)檢驗(yàn),選擇檢驗(yàn)水準(zhǔn)α=0.05,以P0.05表示差異具有統(tǒng)計(jì)學(xué)意義。結(jié)果:(1)研究對(duì)象一般情況:觀察組男性13例,女性17例,年齡6-21歲,平均年齡(14.63±3.36)歲;對(duì)照組男性11例,女性19例,年齡8-19歲,平均年齡(15.07±2.15)歲。兩組患者在一般資料方面差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。(2)研究結(jié)果顯示:?觀察組術(shù)后各時(shí)間點(diǎn)VAS評(píng)分均低于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。?術(shù)后3d患者鎮(zhèn)痛的滿(mǎn)意度各項(xiàng)目評(píng)分,觀察組均高于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。?S-AI狀態(tài)焦慮量表評(píng)分中,觀察組和對(duì)照組在術(shù)前的S-AI評(píng)分,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。而兩組在術(shù)后36h的焦慮評(píng)分,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。對(duì)照組在術(shù)前和術(shù)后36h的焦慮評(píng)分,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。觀察組術(shù)后36h的評(píng)分低于術(shù)前,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(4)觀察組的首次功能鍛煉時(shí)間和住院時(shí)間均早于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(5)觀察組不良反應(yīng)發(fā)生5例(16.67%),對(duì)照組不良反應(yīng)發(fā)生10例(33.33%),兩組之間差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:以護(hù)士為主體的MMA應(yīng)用于脊柱側(cè)彎患者圍手術(shù)期,可以有效緩解術(shù)后疼痛,提升患者滿(mǎn)意度,優(yōu)化醫(yī)護(hù)服務(wù)質(zhì)量;能夠減輕患者的焦慮情況及心理壓力;縮短住院時(shí)間,加快康復(fù)鍛煉,降低不良反應(yīng)發(fā)生,促進(jìn)患者快優(yōu)康復(fù)。
[Abstract]:Objective: to observe the effect of multi-mode analgesia (MMA) with nurses as the main body in the perioperative period of scoliosis, and to explore the applicability of multi-mode analgesia in perioperative period of scoliosis. The purpose of this study was to provide scientific guidance and evidence-based basis for nursing care, to alleviate patients' pain, to provide quality nursing services, and to explore the role and significance of nurses in pain management system. Objects and methods: the method of experimental study was adopted. Sixty patients with scoliosis who were scheduled to perform osteotomy and orthopedic surgery in a hospital from June to July 2017 were selected as the study object. 30 patients with scoliosis were selected as the control group and 30 patients as the observation group from June 10 to July 2017.2. The control group was treated with routine on demand analgesia, while the observation group was treated with MMA with nurses as the main body. The pain scores of the two groups at different time points were compared. The scores of S-AI state anxiety scale, analgesic satisfaction, postoperative recovery and the occurrence of adverse opioid drug reactions were compared between the two groups. To observe the effect of MMA with nurses as the main body in the perioperative period of scoliosis. SPSS software was used to test the data with t test and ANOVA 17) test. The test level was 0. 05, and the difference was statistically significant (P 0. 05). Results the general situation of the subjects: there were 13 males and 17 females, aged 6-21 years, with an average age of 14.63 鹵3.36 years in the observation group, and 11 males and 19 females in the control group, aged 8-19 years, with an average age of 15.07 鹵2.15 years. There was no significant difference in general data between the two groups. The VAS score of the observation group was lower than that of the control group at all time points after operation, and the difference was statistically significant (P 0.05). The scores of patients' analgesic satisfaction were higher in the observation group than in the control group on the 3rd day after operation. The difference was statistically significant (P 0.05). There was no significant difference between the observation group and the control group in the preoperative S-AI score (P 0.05). There was significant difference in anxiety score between the two groups at 36 hours after operation (P 0.05). There was no significant difference in anxiety score between preoperative and postoperative 36 hours in the control group (P 0.05). The scores of 36 hours after operation in the observation group were lower than those in the preoperative group, the difference was statistically significant (P < 0.05) the first time of functional exercise and the time of hospitalization in the observation group were earlier than those in the control group. The difference was statistically significant (P 0.05).) there were 5 cases of adverse reactions in the observation group and 10 cases in the control group. The difference between the two groups was statistically significant (P 0.05). Conclusion: the application of MMA with nurses as the main body in the perioperative period of scoliosis can effectively relieve postoperative pain, improve the satisfaction of patients, optimize the quality of medical care, relieve anxiety and psychological pressure of patients, shorten the length of stay in hospital. Speed up rehabilitation exercise, reduce the occurrence of adverse reactions, and promote the rapid rehabilitation of patients.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R473.6

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