梅雨柳　曹伟　裘伟琪

[摘要] 目的 探討无线镇痛泵系统用于骨科手术患者术后镇痛管理的可行性及有效性。 方法 将600例骨科术后患者分为两组，使用无线镇痛泵系统镇痛的300例患者为A组，使用传统电子镇痛泵镇痛的300例患者为B组。观察两组患者术后出PACU、术后24 h、48 h、72 h的疼痛强度，按压自控镇痛键的总次数，有效按压次数及镇痛不足次数；记录两组医务人员服务患者的有效处理时间、被叫服务率和主动服务率；测评患者对镇痛治疗的满意度及观察镇痛药物引起的不良反应的发生率。 结果 两组患者术后各观察时间点的疼痛强度比较，差异无统计学意义（P>0.05）；患者按压自控镇痛键的总次数，有效按压次数及镇痛不足次数两组间比较，差异均无统计学意义（P>0.05）。医务人员服务患者的有效处理时间：A组为（10.0±2.33）min，B组为（16.0±3.09）min，差异有统计学意义（P<0.05）；B组患者的被叫服务率显著高于A组，而A组患者的主动服务率显著高于B组（P<0.05）。A组患者的镇痛满意度显著高于B组，差异有统计学意义（P<0.05），两组患者关于镇痛药物引起的不良反应发生率无明显差异（P>0.05）。 结论 无线镇痛泵系统用于骨科手术患者术后镇痛，安全可行，有助于个体化镇痛管理，提高术后疼痛管理质量。

[关键词] 骨科手术；术后疼痛；镇痛管理；无线镇痛泵系统

[中图分类号] R473.6 [文献标识码] B [文章编号] 1673-9701（2017）24-0099-05

[Abstract] Objective To explore the feasibility and effectiveness of wireless analgesic pump system in postoperative analgesia management in patients receiving orthopedic surgery. Methods A total of 600 patients after orthopedic surgery were divided into two groups. 300 patients who were given analgesia with the use of wireless analgesic pump system were assigned to group A， and 300 patients who were given analgesia with the use of traditional electronic analgesia pump were assigned to group B. The pain intensity upon discharge from PACU， 24 h， 48 h and 72 h after operation， the total number of pressing the self-controlled analgesic button， the number of effective presses and the number of insufficient analgesia were observed in both groups； the effective treatment time， called service rate and active service rate of the two groups of medical staff serving the patients were recorded； the patient's satisfaction with analgesic treatment was measured， and the incidence rate of adverse reactions caused by analgesic drugs was observed. Results There was no statistically significant difference in pain intensity between the two groups at each observation time point after the surgery（P>0.05）； there were no statistically significant differences in the total number of pressing the self-controlled analgesic button， the number of effective presses and the number of insufficient analgesia between the two groups （P>0.05）. For the effective treatment time of medical staff serving the patients： （10.0±2.33） min in group A， and （16.0±3.09） min in group B. The differences were statistically significant（P<0.05）； the called service rate in group B was significantly higher than that in group A， while the active service rate in group A was significantly higher than that in group B. The difference was statistically significant （P<0.05）. The satisfaction rate with analgesia in group A was significantly higher than that in group B， and the difference was statistically significant（P<0.05）. There was no significant difference in the incidence rate of adverse events caused by analgesic drugs between the two groups （P>0.05）. Conclusion The wireless analgesic pump system for postoperative analgesia in patients receiving orthopedic surgery is safe and feasible， which can help individualized analgesic management and improve the quality of postoperative pain management.endprint

[Key words] Orthopedic surgery； Postoperative pain； Analgesic management； Wireless analgesic pump system

无法有效控制的术后疼痛一直是很多患者面对手术治疗的最主要顾虑。术后急性疼痛是增加术后并发症和死亡率的重要因素[1]。在过去的 20 年里，关于控制术后疼痛的新技术正在逐渐涌现，并被广泛应用于众多医疗机构中[2]。但研究发现，虽然新的镇痛技术和新型镇痛药物不断出现，但患者急性疼痛仍没得到有效缓解[3]，尤其是骨科患者疼痛程度仍然相当的剧烈。应用微处……