摘 要
骨折术后疼痛管理是临床护理的重要课题，传统单一镇痛模式难以满足患者需求。本研究旨在探讨多模式护理干预对骨折术后患者疼痛管理的效果及临床应用价值。采用随机对照试验设计，选取2022年1月至2023年6月某三甲医院骨科收治的120例骨折手术患者为研究对象，随机分为对照组和观察组各60例。对照组采用常规术后护理，观察组实施多模式护理干预，包括术前心理疏导、术中体温管理、术后早期活动指导、音乐疗法及个体化镇痛方案等综合措施。通过视觉模拟评分法评估疼痛程度，采用匹兹堡睡眠质量指数评价睡眠质量，并记录术后并发症发生率及住院时间等指标。研究结果显示，观察组术后24h、48h、72h的VAS评分显著低于对照组，且PSQI评分改善明显。观察组术后并发症发生率为8.33%，显著低于对照组的21.67%，平均住院时间缩短2.3天。
关键词：多模式护理干预;骨折术后疼痛;视觉模拟评分法
Abstract
Postfracture pain management is an important topic in clinical care, and the traditional single analgesic model is difficult to meet the needs of patients. This study aims to investigate the effectiveness and clinical utility of multimodal nursing intervention in pain management in patients after fracture surgery. Using a randomized controlled trial design, 120 fracture surgery patients admitted to the orthopedic department of a Grade A hospital from January 2022 to June 2023 were selected as study subjects, randomly divided into control group and observation group. The control group adopted routine postoperative care, and the observation group implemented multimodal nursing intervention, including comprehensive measures such as preoperative psychological counseling, intraoperative temperature management, early postoperative activity guidance, music therapy and individualized analgesia regimen. Pain level was assessed by visual analogue scoring, sleep quality was assessed using the Pittsburgh Sleep Quality Index, and postoperative complication rate and length of hospital stay were recorded. The results showed that the VAS scores of the observation group at 24h, 48h and 72h after surgery were significantly lower than that of the control group, and the PSQI score improved significantly. The incidence of postoperative complications in the observation group was 8.33%, which was significantly lower than 21.67% in the control group, and the mean hospital stay decreased by 2.3 days.
Keywords：Multimodal nursing intervention; postoperative fracture pain; visual analog rating method
目 录
引 言 1
第一章 骨折术后疼痛管理现状分析 2
1.1 骨折术后疼痛的临床特征 2
1.2 传统疼痛管理方法的局限性 2
1.3 多模式护理理念的发展趋势 3
第二章 多模式护理的理论基础与实践框架 4
2.1 多模式护理的核心概念解析 4
2.2 疼痛管理的生理-心理-社会模型 4
2.3 多模式护理的实施原则 5
第三章 多模式护理在骨折术后的应用研究 7
3.1 研究对象与方法设计 7
3.2 药物与非药物干预的协同效应 7
3.3 患者自我管理能力的培养策略 8
3.4 护理效果评价指标体系 8
第四章 多模式护理的优化与推广策略 10
4.1 基于循证医学的护理方案优化 10
4.2 跨学科协作模式的建立与完善 10
4.3 信息化技术在疼痛管理中的应用 11
4.4 多模式护理的质量控制体系 11
结 论 13
参考文献 14
致 谢 15
骨折术后疼痛管理是临床护理的重要课题，传统单一镇痛模式难以满足患者需求。本研究旨在探讨多模式护理干预对骨折术后患者疼痛管理的效果及临床应用价值。采用随机对照试验设计，选取2022年1月至2023年6月某三甲医院骨科收治的120例骨折手术患者为研究对象，随机分为对照组和观察组各60例。对照组采用常规术后护理，观察组实施多模式护理干预，包括术前心理疏导、术中体温管理、术后早期活动指导、音乐疗法及个体化镇痛方案等综合措施。通过视觉模拟评分法评估疼痛程度，采用匹兹堡睡眠质量指数评价睡眠质量，并记录术后并发症发生率及住院时间等指标。研究结果显示，观察组术后24h、48h、72h的VAS评分显著低于对照组，且PSQI评分改善明显。观察组术后并发症发生率为8.33%，显著低于对照组的21.67%，平均住院时间缩短2.3天。
关键词：多模式护理干预;骨折术后疼痛;视觉模拟评分法
Abstract
Postfracture pain management is an important topic in clinical care, and the traditional single analgesic model is difficult to meet the needs of patients. This study aims to investigate the effectiveness and clinical utility of multimodal nursing intervention in pain management in patients after fracture surgery. Using a randomized controlled trial design, 120 fracture surgery patients admitted to the orthopedic department of a Grade A hospital from January 2022 to June 2023 were selected as study subjects, randomly divided into control group and observation group. The control group adopted routine postoperative care, and the observation group implemented multimodal nursing intervention, including comprehensive measures such as preoperative psychological counseling, intraoperative temperature management, early postoperative activity guidance, music therapy and individualized analgesia regimen. Pain level was assessed by visual analogue scoring, sleep quality was assessed using the Pittsburgh Sleep Quality Index, and postoperative complication rate and length of hospital stay were recorded. The results showed that the VAS scores of the observation group at 24h, 48h and 72h after surgery were significantly lower than that of the control group, and the PSQI score improved significantly. The incidence of postoperative complications in the observation group was 8.33%, which was significantly lower than 21.67% in the control group, and the mean hospital stay decreased by 2.3 days.
Keywords：Multimodal nursing intervention; postoperative fracture pain; visual analog rating method
目 录
引 言 1
第一章 骨折术后疼痛管理现状分析 2
1.1 骨折术后疼痛的临床特征 2
1.2 传统疼痛管理方法的局限性 2
1.3 多模式护理理念的发展趋势 3
第二章 多模式护理的理论基础与实践框架 4
2.1 多模式护理的核心概念解析 4
2.2 疼痛管理的生理-心理-社会模型 4
2.3 多模式护理的实施原则 5
第三章 多模式护理在骨折术后的应用研究 7
3.1 研究对象与方法设计 7
3.2 药物与非药物干预的协同效应 7
3.3 患者自我管理能力的培养策略 8
3.4 护理效果评价指标体系 8
第四章 多模式护理的优化与推广策略 10
4.1 基于循证医学的护理方案优化 10
4.2 跨学科协作模式的建立与完善 10
4.3 信息化技术在疼痛管理中的应用 11
4.4 多模式护理的质量控制体系 11
结 论 13
参考文献 14
致 谢 15
