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目的:观察超前镇痛管理在经皮椎体成形术患者中的镇痛效果。方法:选择我院2012年1月至2014年12月,因单个椎体新鲜压缩性骨折行经皮椎体成形术的患者共120例,采用随机分组单盲法将患者分为超前镇痛管理治疗组(帕瑞昔布组)和安慰剂治疗组(安慰剂组),以VAS评分法记录患者疼痛情况。分别用帕瑞昔布和安慰剂在患者入手术室前30 min静脉推注,记录2组患者的疼痛程度,以最高值为准。同时记录穿刺前及手术结束患者转为平卧位回到病房后共2个时点时,患者血压、心率的变化。评定患者对手术前后疼痛控制的满意度。于手术后48 h内观察记录患者恶心、呕吐、腹部不适等不良反应发生情况,同时评定患者对手术前后疼痛控制的满意度。结果:治疗前2组患者疼痛评分比较差异无统计学意义(P>0.05),穿刺前及手术结束患者转为平卧位回病房后2组疼痛评分比较差异有统计学意义(P<0.05)。2组术后不良反应及满意度比较帕瑞昔布组均优于安慰剂组。结论:术前常规疼痛护理干预加静脉推注帕瑞昔布可发挥超前镇痛效应,能减轻患者术后不良反应发生率及降低疼痛评分,提高了患者生活质量,从而提高了患者住院的满意度。
Objective: To observe the analgesic effect of advanced analgesia management in percutaneous vertebroplasty. Methods: From January 2012 to December 2014, a total of 120 patients undergoing percutaneous vertebroplasty with fresh vertebral compression fractures were enrolled. Patients were divided into two groups according to randomized single-blinded management: Group (Parecoxib group) and placebo group (placebo group), the pain was recorded by VAS score. Patients were injected with parecoxib and placebo intravenously 30 minutes before the operating room, recording the degree of pain in two groups of patients, whichever is highest. At the same time, the changes of blood pressure and heart rate of the patients before and after the operation were recorded when the patient turned to the supine position and returned to the ward for a total of 2 hours. Assess patient satisfaction with pre and postoperative pain control. The incidence of nausea, vomiting, abdominal discomfort and other adverse reactions were observed and recorded within 48 hours after surgery. Patients’ satisfaction with the control of pain before and after surgery was also assessed. Results: There was no significant difference in pain scores between the two groups before treatment (P> 0.05). There was significant difference in pain scores between the two groups before and after the operation (P <0.05) . Adverse reactions and satisfaction in the two groups were better than the placebo group in the parecoxib group. Conclusion: Preoperative routine nursing intervention and intravenous injection of parecoxib can exert the advanced analgesic effect, which can reduce the incidence of postoperative adverse reactions and reduce the pain scores, improve the quality of life of patients and improve the patient’s hospitalization degree.