改良的急性疼痛服务模式在足踝骨折病人术后的效果研究

目的:研究以护士为基础、以临床医生和麻醉医生为督导的急性疼痛服务模式 （NBASS-APS）在足踝骨折病人术后疼痛管理中的应用效果。方法:将符合纳入标准的64例足踝骨折手术病人作为研究对象，随机分为干预组和对照组，各32例，干预组给予以护士为基础、以临床医生和麻醉医生为督导的NBASS-APS；对照组采取传统的急性疼痛服务模式，由病区护士和医生实施术后镇痛管理。比较2组病人术后镇痛效果、术后24h、48h内睡眠时间及术后住院时间情况及病人对术后疼痛管理效果的满意度。结果:干预组病人在10分制的视觉模拟量表（VAS）的四个指标VASmax、meanVAS、Tmax、PVAS的得分上均低于对照组（P<0.05~P<0.01）；且干预组病人术后24h和48h睡眠时长多于对照组（P<0.05），住院时间明显短于对照组（P<0.01）；干预组病人术后镇痛效果的满意度明显优于对照组（P<0.01）。结论:NBASS-APS应用于足踝骨折手术病人能有效地降低疼痛水平，恢复生理功能，提高病人的满意度，适合于临床应用。

Study on the effect of NBASS-APS model on postoperative patients with ankle fracture

Objective:To study the application effects of the improved nurse-based and anesthesiologist and specialist-supervised acute pain management system(NBASS-APS) in postoperative patients with ankle fracture.Methods:A total of 64 patients with ankle fractures were randomly divided into the intervention group(n=32) and control group(n=32).The intervention group was nursed using NBASS-APS,and the control group was nursed using the routine acute pain service model.The postoperative analgesic effect,sleep time after 24 h and 48 h of operation,hospital stay and patients' satisfaction between two groups were compared.Results:The scores of VASmax,meanVAS,Tmax and PVAS in intervention group were lower than those in control group(P<0.05 to P<0.01),and the sleep time in intervention group after 24 h and 48 h of operation were longer than those in control group(P<0.05).The hospital stay in intervention group was significantly shorter than that in control group(P<0.01),and the patients' satisfaction on analgesic effect in intervention group was significantly better than that in control group(P<0.01).Conclusions:The application of NBASS-APS in patients with ankle fracture can effectively reduce pain,recover physiological function and improve patients' satisfaction,which is suitable for clinical use.