基于移动互联网的虚拟无痛病房对开颅手术后患者疼痛管理的效果

doi:10.3969/j.issn.1006-9771.2021.02.017

Abstract

Abstract: Objective

To evaluate the effect of virtual painless ward management based on mobile internet on pain management of patients after craniotomy.

Methods

From May to October, 2019, 117 patients who accepted virtual painless ward management based on mobile Internet after craniotomy were selected as painless ward group. From December, 2018 to April, 2019, 117 patients previously hospitalized in the same department after craniotomy were selected as control group. The regression equation was established to compare the Numerical Rating Scale (NRS), nursing satisfaction and anxiety rate between two groups, and the general data, such as age, were taken as independent variables into the regression equation. Partial regression coefficient (B), odds ratio (OR) and 95% confidence interval (CI) of the painless ward management after adjustment compared with that of the non-painless ward management were calculated.

Results

Multivariate regression analysis showed that, compared with the control group, the score of NRS within four days significantly decreased (B = -2.700, 95%CI -3.167 to -2.232, P < 0.001), the nursing satisfaction significantly increased (B = 0.542, 95%CI 0.289 to 0.795, P < 0.001), and the anxiety rate significantly decreased (B = -2.119, OR = 0.120, 95%CI0.053 to 0.271, P < 0.001) in the painless ward group. However, the improvement of the anxiety rate might not completely depend on the decrease of NRS score (B = -0.112, OR = 0.894, 95%CI 0.727 to 1.100, P > 0.05).

Conclusion

The procedure of virtual painless ward based on mobile internet could obviously improve the management level of analgesia for patients after craniotomy.

Key words: virtual painless ward, craniotomy, pain, nursing satisfaction, anxiety

CLC Number:

R614

Na HUANG,Hui-xin ZHANG,Hao REN,Yu-qi GUO. Effect of Virtual Painless Ward Based on Mobile Internet on Pain Management for Patients after Craniotomy[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(2): 222-229.

Figures/Tables 5

References 35

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项目	对照组(n = 117)	无痛病房组(n = 117)	t/χ²值	P值
年龄(岁)	54.6±8.3	55.8±10.2	-1.059	0.291
女性(n)	61	68	0.847	0.358
BMI (kg/m²)	24.4±2.6	22.8±3.6	4.055	< 0.001
受教育程度(n)			6.633	0.025
小学	8	8
中学	66	47
大专及以上	43	62
既往开颅手术史(n)	11	10	0.052	0.819
慢性头痛病史(n)	29	16	4.650	0.031
颈椎病病史(n)	23	18	0.739	0.390
慢性并发症(n)
高血压	21	27	0.944	0.331
冠心病	9	13	0.803	0.370
糖尿病	6	12	2.167	0.141
脑血管病	3	8	2.385	0.123
手术切口部位(n)			4.709	0.185
额部	17	30
颞部	61	55
顶部	36	29
枕部	3	3
恶性肿瘤(n)	55	51	0.276	0.599
阿片类药物用量(μg)	54.1±18.3	40.3±16.7	5.990	< 0.001

自变量及赋值	B	95% CI		P值
是否接受无痛病房管理(0 =否，1 =是)	-2.700	-3.167	-2.232	< 0.001
年龄	0.011	-0.013	0.036	0.367
性别(1=女，2=男)	0.018	-0.411	0.447	0.935
BMI	0.010	-0.057	0.078	0.765
文化程度(1 =小学，2 =中学，3=大专及以上)	-0.088	-0.435	0.258	0.616
以往进行过开颅手术(0 =否，1 =是)	0.200	-0.530	0.929	0.590
慢性头痛病史(0 =否，1 =是)	0.230	-0.301	0.761	0.394
颈椎病病史(0 =否，1 =是)	-0.064	-0.606	0.479	0.817
高血压(0 =否，1 =是)	-0.416	-0.947	0.115	0.124
冠心病(0=否；1=是)	-0.551	-1.278	0.176	0.137
糖尿病(0 =否，1 =是)	0.021	-0.777	0.819	0.959
脑血管病(0 =否，1 =是)	0.065	-0.951	1.081	0.900
手术切口部位(1 =额部，2 =颞部，3 =顶部，4 =枕部)	-0.140	-0.420	0.140	0.324
肿瘤性质(1 =良性，2 =恶性)	0.023	-0.398	0.444	0.913
镇痛泵药物使用量	0.033	0.021	0.045	< 0.001
常数	3.975	1.182	6.768	0.005

自变量及赋值	B	95% CI		P值
是否接受无痛病房管理(0 =否，1 =是)	0.542	0.289	0.795	< 0.001
年龄	0.006	-0.007	0.020	0.341
性别(1=女，2=男)	-0.086	-0.318	0.146	0.468
BMI	-0.001	-0.037	0.036	0.962
文化程度(1 =小学，2 =中学，3=大专及以上)	-0.080	-0.268	0.108	0.402
以往进行过开颅手术(0 =否，1 =是)	-0.007	-0.402	0.388	0.971
慢性头痛病史(0 =否，1 =是)	0.073	-0.214	0.361	0.616
颈椎病病史(0 =否，1 =是)	0.206	-0.088	0.499	0.169
高血压(0 =否，1 =是)	0.102	-0.186	0.390	0.485
冠心病(0=否；1=是)	-0.087	-0.480	0.307	0.665
糖尿病(0 =否，1 =是)	-0.089	-0.521	0.343	0.684
脑血管病(0 =否，1 =是)	-0.166	-0.716	0.384	0.553
手术切口部位(1 =额部，2 =颞部，3 =顶部，4 =枕部)	0.022	-0.129	0.174	0.771
肿瘤性质(1 =良性，2 =恶性)	-0.184	-0.412	0.044	0.113
镇痛泵药物使用量	-0.002	-0.009	0.004	0.487
常数	4.132	2.620	5.644	< 0.001

自变量及赋值	B	OR值	OR值的95% CI		P值
是否接受无痛病房管理(0 =否，1 =是)	-2.119	0.120	0.053	0.271	< 0.001
年龄	0.002	0.942	0.483	1.838	0.914
性别(1 =女，2 =男)	-0.060	0.950	0.849	1.063	0.861
BMI	-0.051	1.275	0.731	2.224	0.370
文化程度(1 =小学，2 =中学，3 =大专及以上)	0.243	0.487	0.141	1.675	0.392
以往进行过开颅手术(0 =否，1 =是)	-0.720	1.488	0.693	3.198	0.254
慢性头痛病史(0 =否，1 =是)	0.398	0.732	0.309	1.734	0.308
颈椎病病史(0 =否，1 =是)	-0.312	1.374	0.606	3.117	0.478
高血压(0 =否，1 =是)	0.318	0.902	0.275	2.960	0.447
冠心病(0 =否，1 =是)	-0.103	0.745	0.189	2.930	0.865
糖尿病(0 =否，1 =是)	-0.295	0.876	0.150	5.109	0.673
脑血管病(0 =否，1 =是)	-0.132	1.210	0.778	1.880	0.883
手术切口部位(1 =额部，2 =颞部，3 =顶部，4 =枕部)	0.190	1.347	0.694	2.617	0.397
肿瘤性质(1 =良性，2 =恶性)	0.298	0.998	0.980	1.017	0.379
镇痛泵药物使用量	-0.002	0.706	0.965	1.041	0.853
常数	-0.347	1.002			0.879

自变量及赋值	B	OR值	OR的95% CI		P值
是否接受无痛病房管理(0 =否，1 =是)	-2.417	0.089	0.033	0.241	< 0.001
年龄	0.004	1.004	0.966	1.044	0.826
性别(1 =女，2 =男)	-0.074	0.929	0.475	1.817	0.829
BMI	-0.049	0.952	0.850	1.066	0.392
文化程度(1 =小学，2 =中学，3 =大专及以上)	0.233	1.263	0.722	2.207	0.413
以往进行过开颅手术(0 =否，1 =是)	-0.692	0.500	0.145	1.722	0.272
慢性头痛病史(0 =否，1 =是)	0.447	1.563	0.724	3.374	0.255
颈椎病病史(0 =否，1 =是)	-0.330	0.719	0.301	1.716	0.457
高血压(0 =否，1 =是)	0.265	1.304	0.570	2.983	0.530
冠心病(0 =否，1 =是)	-0.194	0.824	0.246	2.763	0.754
糖尿病(0 =否，1 =是)	-0.254	0.775	0.197	3.046	0.715
脑血管病(0 =否，1 =是)	-0.139	0.870	0.148	5.097	0.877
手术切口部位(1 =额部，2 =颞部，3 =顶部，4 =枕部)	0.162	1.176	0.753	1.836	0.476
肿瘤性质(1 =良性，2 =恶性)	0.284	1.328	0.684	2.581	0.402
镇痛泵药物使用量	0.003	1.003	0.983	1.023	0.790
NRS评分	-0.112	0.894	0.727	1.100	0.290
常数	0.059	1.060			0.980

Effect of Virtual Painless Ward Based on Mobile Internet on Pain Management for Patients after Craniotomy

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