摘要目的 探讨以护士为主体的多学科合作疼痛管理模式对加速肺癌胸腔镜手术治疗患者快速康复的作用.方法 选择浙江省台州医院心胸外科2014年7—12月择期胸腔镜手术治疗的肺癌患者96例为对照组,2016年1—6月择期胸腔镜手术治疗的肺癌患者91例为试验组,试验组采用以护士为主体的多学科合作疼痛管理模式进行术后急性疼痛管理,对照组采用传统的管理方式;观察并比较两组患者在中重度疼痛发生、首次下床时间、术后并发症发生、平均住院时间等方面的差异.结果 试验组24 h内发生的NRS评分为4.65分,低于对照组的3.25分,中重度疼痛发生率为6.59%,低于对照组的16.67%,差异有统计学意义(t/χ2值分别为-2.247、4.567;P<0.05);试验组首次下床时间(19.11±7.49)h、平均住院时间(9.34±3.66)d,对照组首次下床时间(27.40±11.91)h,平均住院时间(10.98±5.01)d,差异有统计学意义(t值分别为-4.766、-2.024;P<0.05),在术后并发症发生上两组差异无统计学意义(P>0.05).结论 护士在多学科合作疼痛管理中的作用日益突显,该模式能有效促进患者术后快速康复,同时加速了护理学科的专业化发展进程.

abstractsObjective To explore the effect of pain management model of the nurse-centered multidisciplinary cooperation on quick recovery in lung cancer patients with video-assisted thoracoscopic surgery vats (VATS).Methods A total of 96 lung cancer patients with selective VATS in Department of Cardio-Thoracic Surgery of Taizhou Hospital of Zhejiang Province were selected as control group from July 2014 to December 2014. A total of 91 lung cancer patients with selective VATS were chosen as experimental group between January 2016 to June 2016. Patients received postoperative acute pain management with the pain management mode of nurse-centered multidisciplinary cooperation in experimental group and traditional management model in control group. The differences were observed and compared among patients between two groups in the occurrence of moderate-severe pain,time of first ambulation,occurrence of postoperative complications,average hospital stay and so on. Results The score of NRS,incidence of moderate-severe pain in experimental group (3.25,6.59%) were lower than those (4.65,16.67%) in control group within 24 hours with significant differences (t/χ2=-2.247,4.567;P<0.05). There were statistically significant differences in the time of first ambulation and average hospital stay between experimental group [(19.11±7.49) h,(9.34±3.66) d] and control group [(27.40±11.91) h, (10.98±5.01) d] (t=-4.766,-2.024;P<0.05). There was no statistically significant difference in the occurrence of postoperative complications between two groups (P>0.05).Conclusions The importance of nurses in pain management of multidisciplinary cooperation becomes increasingly. The model can effectively promote quick recovery in postoperative patients and speed up the process of nursing professional development.