李云莉+宗允

摘 要 目的：探讨中文版晚期老年痴呆症疼痛评估量表（C-PAINAD）在存在认知障碍的压力性损伤（PI）患者中的应用效果. 方法：将68名认知障碍并PI患者按照入院时间先后顺序分为实验组和对照组各34例。对照组按我院常规“预防压疮制度”护理，只进行Braden评分和护理；实验组在此基础上应用C-PAINAD进行评估，当疼痛评分提示疼痛增加时，则加强PI的预防措施。结果：实验组患者好转和痊愈比例均高于对照组，扩大或形成难免压疮比率低于对照组，但组间无统计学差异（P>0.05）。结论：C-PAINAD的临床应用能够准确反应认知障碍患者受压部分的疼痛，使认知障碍并PI患者的防治更加靠前，提前干预，一定程度上，可降低压力性损伤的发生和进展。

关键词 压力性损伤 疼痛评估 晚期老年痴呆疼痛评估量表

中图分类号：R749.16 文献标识码：B 文章编号：1006-1533（2017）21-0059-02

Application of C-PAINAD in 34 patients with cognitive impairment and stress injury*

LI Yunli， ZONG Yun

（Department of Nursing， The Third Hospital of Nanchang， Nanchang 330002， China）

ABSTRACT Objective： To explore the effects of the C-PAINAD on pressure injury （PI） patients with cognitive impairment. Methods： Sixty-eight patients with cognitive impairment and PI were divided into an experimental group and a control group with 34 cases each based on the time of admission. The control group underwent only Braden score and nursing based on the conventional ‘prevention system care in our hospital while the experimental group was evaluated with the C-PAINAD besides those. The PI preventive measures should be strengthened when the pain score showed pain increase. Results： The ratio of improvement and recovery was higher while the ratio of expansion or formation of inevitable pressure ulcer was lower in the experimental group than in the control group， but there were no statistical differences between the two groups （P>0.05）. Conclusion： The clinical application of C-PAINAD can accurately reflect the compression part of the cognitive impairment in patients with pain， cognitive impairment and the early prevention and treatment of PI patients can be carried out， so the early intervention can decrease the occurrence and progression of stress injury to a certain extent.

KEy WORDS stress injury； pain assessment； late age dementia pain assessment scale

疼痛作为体温、脉搏、呼吸、血压之后的第五生命体征在临床压力性损伤（pressure injury， PI）护理中未得到足够关注。“压力性损伤”替代了术语“压疮”，更加准确地描述了压力引致的皮肤问题，强调了大多数PI是可以预防的。减轻疼痛在预防PI中具有特殊意义。认知或沟通障碍者由于感觉缺失或表达不利，疼痛易被忽视，因而忽略或错过预防PI进展的最佳时期，延长PI恢复，造成患者的经济损失。

中文版晚期老年痴呆症疼痛评估量表（Chinese pain assessment in advanced dementia scale， C-PAINAD）在评价晚期老年痴呆症这类认知能力严重受损且已失去表达能力的患者疼痛有良好信度和效充[1]。本文探讨C-PAINAD在存在认知障碍的压力性损伤患者中的应用效果。