摘要
目的采用问卷方式调查我国围术期疼痛治疗及管理现状。方法自行设计问卷，在1个月内通过微信平台将该问卷发给全国各医院麻醉科医生，系统自动记录答卷情况。结果共8447位麻醉科医生参与问卷调查，有效问卷6778份，参与调查的麻醉科医生来自全国847家医院，分布于全国31个省市，其中三级医院526家（62．1％），三级以下医院321家（37．9％）。围术期镇痛用药中（不包括麻醉用药），应用以下镇痛药物（包括单独和联合应用）的麻醉科医生比率分别为：阿片类药物79．74％、非甾体类抗炎药53．78％、对乙酰氨基酚25．76％、局麻药（进行神经阻滞）25．44％、其他药物（如氯胺酮、加巴喷丁等）12．39％；联合使用2种及以上药物63．65％。开展术后镇痛泵治疗的医院有649家（76．6％），其中使用PCA泵的医院构成比为43．8％。组建急性疼痛服务小组（APS）的医院475家（56．1％），三级医院APS组建率高于三级以下医院（P〈0．01），APS人员构成以麻醉科医生为主（72．4％）。结论我国围术期疼痛治疗中多模式镇痛尚未广泛普及，非甾体类抗炎药及神经阻滞使用率较低；术后镇痛泵应用广泛，但PCA技术应用率不高；疼痛管理中APS建设相对薄弱，麻醉科医生在APS中起到主导作用。
Objective To investigate the current situation of perioperative pain treatment and management using questionnaire survey.Methods A questionnaire was designed by ourselves and sent to anesthesiologists in each hospital all over China via the WeChat platform within 1 month.The system automatically recorded the situation of questionnaires.Results A total of 8 447 anesthesiologists involved in the investigation, the number of valid questionnaires retrieved was 6 778, anesthesiologists in the survey came from 847 hospitals in China, distributing across China 31 provinces and cities, and there were 526 tertiary hospitals（62.1%）and 321 hospitals under tertiary grade（37.9%）. Among the medication for perioperative analgesia（not including medication for anesthesia）, the following analgesics（applied alone or in combination）were used by anesthesiologists, and the application rate was as follows： opioids 79.74%, non-steroidal anti-inflammatory drugs 53.78%, paracetamol 25.76%, local analgesics for analgesia（for nerve blockade）25.44%, other drugs（such as ketamine, gabapentin）12.39%; combination of two or more drugs 63.65%.Six hundred forty-nine hospitals（76.6%）carried out therapy with analgesic pump after operation, and the constituent ratio of hospitals using patient-controlled analgesia（PCA）pump was 43.8%.Four hundred seventy-five hospitals（56.1%）established Acute Pain Service（APS）, the organizing rate of APS was significantly higher in tertiary hospitals than in hospitals under tertiary grade（P〈0.01）, and the majority of APS personnel was anesthesiologists（72.4%）.Conclusion Multimodal analgesia and PCA technique are not widely adopted and the requirement for non-steroidal anti-inflammatory drugs and nerve blockade is lower in perioperative pain treatment in China; analgesic pump is widely used after operation, but the application rate of PCA technique is not high; APS establishment is relatively weak in pain management and anesthesiologists play a leading role in APS.
作者
张庆芬
张冉
何苗
安海燕
冯艺
黄宇光
Zhang Qingfen;Zhang Ran;He Miao;An Haiyan;Feng Yi(Department of Anesthesiology, Peking University People＇s Hospital, Belting 100044, China;Department of Anesthesiology, Peking Union Medical College Hospital Peking Union Medical College Chinese Academy of Medical Sciences, Beifing 100730, China)
出处
《中华麻醉学杂志》
CSCD
北大核心
2017年第12期1409-1413,共5页
Chinese Journal of Anesthesiology
关键词
问卷调查
镇痛
Questionnaires
Analgesia
