摘要
目的研究基于临床路径(CP)精细化管理手段的镇痛模式对骨科关节手术患者术后镇痛效果、恢复情况及认知功能的影响。方法选择2018年2月至2021年1月邯郸市中心医院收治的150例骨科关节手术患者,采用随机数字表法分为观察组(采取基于CP精细化管理手段的镇痛模式进行治疗)与对照组(采取常规镇痛治疗),每组75例。对比两组患者的镇痛效果、恢复情况、认知功能、术后并发症发生率差异。结果观察组患者术后2、6、12、24 h的视觉模拟量表(VAS)评分均低于对照组,差异有统计学意义(均P<0.05)。术后24 h,两组患者日本骨科协会(JOA)评分均较治疗前降低,直腿抬高试验角度均较治疗前增大(均P<0.05),且观察组患者JOA评分低于对照组,直腿抬高试验角度大于对照组,差异有统计学意义(均P<0.05)。术后24 h,两组患者简易智力状态检查量表(MMSE)评分均升高(均P<0.05),且观察组患者MMSE评分高于对照组,差异有统计学意义(均P<0.05)。观察组患者术后恶心、呕吐发生率显著少于对照组,差异有统计学意义(均P<0.05)。结论基于CP精细化管理手段的镇痛模式提高了骨科关节手术患者术后镇痛效果、恢复情况及认知功能,建议临床推广。
Objective To investigate the impact of a pain management model based on clinical pathway(CP)refinement on postoperative pain relief,recovery,and cognitive function in patients undergoing orthopedic joint surgery.Methods A total of 150 orthopedic joint surgery patients admitted to Handan Central Hospital from February 2018 to January 2021 were selected.They were randomly divided into an observation group(treated with a pain management model based on CP refinement)and a control group(treated with conventional pain management)using a random number table method,with 75 patients in each group.We compared the differences in pain relief,recovery,cognitive function,and postoperative complication rates between two groups of patients.Results The Visual Analogue Scale(VAS)scores of the observation group patients at 2,6,12,and 24 hours after surgery were lower than those of the control group,and the differences were statistically significant(all P<0.05).24 hours after surgery,the Japanese Orthopaedic Association(JOA)scores of both groups of patients decreased compared to before treatment,and the angle of straight leg elevation test increased compared to before treatment(all P<0.05).In addition,the JOA scores of the observation group were lower than those of the control group,and the angle of straight leg elevation test was greater than that of the control group,with statistical significance(all P<0.05).24 hours after surgery,the Mini-mental State Examination(MMSE)scores of both groups of patients increased(all P<0.05),and the MMSE scores of the observation group were higher than those of the control group,with statistical significance(all P<0.05).The incidence of postoperative nausea and vomiting in the observation group was significantly lower than that in the control group,and the difference was statistically significant(all P<0.05).Conclusions The analgesic model based on CP refined management has improved the postoperative analgesic effect,recovery,and cognitive function of patients undergoing orthopedic joint surgery.It is recommended to promote it clinically.
作者
程晶晶
卫晓娜
迟晓慧
石文汇
陈永学
Cheng Jingjing;Wei Xiaona;Chi Xiaohui;Shi Wenhui;Chen Yongxue(Department of Anesthesiology,Handan Central Hospital,Handan 056000,China)
出处
《中国医师杂志》
CAS
2024年第2期205-208,共4页
Journal of Chinese Physician
基金
河北省医学科学研究重点课题计划(20191862)。
关键词
关节成形术
临床路径
镇痛
认知
Arthroplasty
Critical pathways
Analgesia
Cognition
