[1]迟迅,赵德伟,崔大平,等. 全膝关节置换术围手术期规范化疼痛护理管理[J].中华老年骨科与康复电子杂志,2019,(04):223-227.[doi:DOI：10.3877/cma.j.issn.2096-0263.2019.04.008]
　Chi Xun,Zhao Dewei,Cui Daping,et al. Standardized pain nursing management for perioperative total knee arthroplasty[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2019,(04):223-227.[doi:DOI：10.3877/cma.j.issn.2096-0263.2019.04.008]
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 全膝关节置换术围手术期规范化疼痛护理管理
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2019年04期
页码:
223-227
栏目:
护理园地
出版日期:
2019-08-05

文章信息/Info

Title:
 Standardized pain nursing management for perioperative total knee arthroplasty
作者:
 迟迅 ; 赵德伟;  崔大平 ; 郭林 ; 田丰德;  安宁

作者单位：116001 大连大学附属中山医院骨二科
Author(s):
Chi Xun;  Zhao Dewei;  Cui Daping;  Guo Lin;  Tian Fengde;  An Ning.
 The Second Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China
关键词:
 ; 【关键词】 关节成形术; 置换; 膝;  疼痛;  护理;  住院时间
Keywords:
 ; 【Key words】 Arthroplasty;  replacement;  knee;  Pain;  Nursing;  Length of stay
DOI:
DOI：10.3877/cma.j.issn.2096-0263.2019.04.008
文献标志码:
A
摘要:
 【摘要】 目的 观察全膝关节置换术围手术期规范化疼痛护理管理的实施效果。方法 前瞻性收集大连大学附属中山医院2016年8月至2017年12月收治的152例接受全膝关节置换术的患者，采用随机数字表法，分为常规护理组与疼痛管理组，各76例。常规护理组给予常规护理，疼痛管理组应用围手术期规范化疼痛护理管理，比较两组KSS评分、疼痛评分、首次下地时间及住院时间，术后膝关节屈曲≥90°及护理满意度。结果 术后7 d疼痛管理组KSS评分[（89±6）分]、疼痛评分[（4.4±1.6）分]、术后首次下地时间[（22±4）h]及住院时间[（7.3±2.6）d]均显著低于常规护理组[KSS评分：（85±6）分；疼痛评分：（7.4±2.5）分；术后首次下地时间：（35±5）h；住院时间：（15.7±6.9）d]，差异具有统计学意义（t=30.541，P=0.009；t=12.541，P＜0.001；t=13.059，P＜0.001；t=7.022，P＜0.001）。护理满意度（94.7%）高于常规护理组（78.9%），差异具有统计学意义（c2=10.894，P＜0.05）。结论 规范化疼痛护理管理在全膝关节置换术围手术期的应用效果显著，能有效提高患者生活质量，改善患者预后，促进患者恢复健康，值得临床广泛应用及推广。
Abstract:

【Abstract】 Objective To observe the implementation effect of standardized pain management in perioperative period of total knee arthroplasty. Methods A total of 152 patients who underwent total knee arthroplasty were enrolled by prospective collection in the Zhongshan Hospital affiliated to Dalian University from August 2016 to December 2017. Random digital table method was used. Patients were randomly divided into the routine nursing group and the pain management group. Routine care was given to the routine care group. The pain management group used perioperative standardized pain management. The KSS scores, pain scores, first time to go to the hospital and hospital stay, postoperative knee flexion≥90° and nursing satisfaction were compared between the two groups. Results On the 7th postoperative day, the KSS score (89±6), pain score (4.4±1.6), the first ground time (22±4) and hospitalization time (7.3±2.6) in pain management group were all significantly lower than that of the conventional nursing group [KSS score was (85±6), pain score was (7.4±2.5), the first ground time was (35±5), hospitalization time was (15.7±6.9)], the differences were statistically significant (t=30.541, P=0.009; t=12.541, P<0.001; t=13.059, P<0.001; t=7.022, P<0.001). The satisfaction rate of nursing in the pain management group (94.7%) was significantly higher than the routine nursing group (78.9%), the difference was statistically significant (c2=10.894, P<0.05). Conclusion The standardized pain management has a significant effect in the perioperative period of total knee arthroplasty. It can effectively improve the quality of life of patients, improve the prognosis of patients and promote the recovery of patients. It is worthy of clinical application and promotion.

参考文献/References:


1 Xue FS, Liu GP, Sun C, et al. Comparing local infiltration and continuous femoral nerve block for pain relief after total knee arthroplasty [J]. J Arthroplasty, 2016, 31(5): 1133-1134.
2 黄天雯, 陈晓玲, 谭运娟, 等. 疼痛护理质量指标的建立及在骨科病房的应用 [J]. 中华护理杂志, 2015, 50(2): 148-151.
3 汤峙瑜, 冯艺, 安海燕, 等. 住院病人疼痛管理现状及相关因素分析 [J]. 中国疼痛医学杂志, 2018, 24(1): 33-39.
4 中华医学会骨科学分会. 骨关节炎诊治指南(2007版). 中华骨科杂志, 2007, 27(10): 793-796.
5 Izumi M, Ikeuchi M, Aso K, et al. Less deep vein thrombosis due to transcutaneous fibular nerve stimulation in total knee arthroplasty: a randomized controlled trial [J]. Knee Surg Sports TraumatolArthrosc, 2015, 23(11): 3317-3323.
6 成燕, 童莺歌, 刘敏君, 等. 术后活动性疼痛护理评估对疼痛管理质量的影响 [J]. 中华护理杂志, 2015, 50(8): 924-928
7 吴昉, 刘功俭, 谭迎春. 围术期规范化疼痛管理对全膝关节置换 [J]. 徐州医学院学报, 2013, 33(1): 45-48.
8 Nair A. Predictors of persistent pain after total knee arthroplasty [J]. Br J Anaesth, 2016, 116(1): 149-150.
9 Butti L, Bierti O, Lanfrit R, et al. Evaluation of the effectiveness and efficiency of the triage emergency department nursing protocol for the management of pain [J]. J Pain Res, 2017, 10(10): 2479-2488.
10 Rosa WE. Transcultural pain management: theory, practice, and Nurse-Client partnerships [J]. Pain ManagNurs, 2018, 19(1): 23-33.
11 Xue FS, Liu GP, Sun C. Influences of preoperative opioid use on acute pain and analgesic requirement after total knee arthroplasty [J]. ActaAnaesthesiolScand, 2016, 60(5): 682-683.

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备注/Memo

备注/Memo:

基金项目：国家自然科学基金（81201398）
更新日期/Last Update: 2019-09-19