外科患者术后自控镇痛效果的影响因素及对患者结局影响的大数据实证分析
Influencing factors of postoperative patient-controlled analgesia and theirs impact on patient outcome in surgical patients:an analysis based on big data information system
李晓芳 1赵生秀 1李月美 1王云1
作者信息
- 1. 青海省人民医院护理部,西宁市 810007
- 折叠
摘要
目的 基于信息系统大数据,分析影响外科患者术后自控镇痛效果的相关因素,为临床术后镇痛及促进患者康复提供依据.方法 抽取2021年1月至2021年12月青海省人民医院外科术后使用智能化自控镇痛的患者6 527例,采用视觉模拟评分(VAS)评估患者应用镇痛泵期间疼痛发生情况,VAS评分≤3分为轻度或无痛组,VAS评分≥4分为中度及以上疼痛组.通过信息平台调取真实世界大数据,进行单因素分析、logistic回归分析.结果 患者体质量指数(BMI)、美国麻醉医师协会评分(ASA评级)、民族、镇痛泵类型、输血、手术类别、职业均对患者术后疼痛造成影响(P＜0.01或P＜0.05).对两组患者的住院日数、住院费用、术后并发症发生率进行比较,差异具有统计学意义(P＜0.01).结论 BMI、ASA评级、民族、镇痛泵类型、术中输血情况、手术类别、职业均是术后早期中、重度疼痛的独立影响因素,术后疼痛得到良好控制的患者住院日数缩短、住院费用降低、并发症减少.
Abstract
Objective To analyze the factors affecting postoperative patient-controlled analgesia(PCA)in surgical patients based on the large data of information system,and to provide evidence for clinical postoperative analgesia and rehabilitation of patients.Methods Total of 6 527 patients receiving intelligent self-controlled analgesia after surgery in Qinghai Provincial People's Hospital from January 2021 to December 2021 were selected to evaluate the occurrence of pain during the PCA by visual analogue scale(VAS).VAS≤3 was in no pain group and VAS≥4 was in pain group.The real world big data was retrieved through the information platform,and unifactor analysis and binary logistic regression analysis were performed.Results Among the 6 527 patients,2 589 patients were in pain group,the incidence of adverse analgesia was 39.7％.Multivariate regression analysis showed that BMI,ASA,nationality,type of analgesia pump,blood transfusion,type of operation and occupation all affected postoperative pain(P＜0.01 or P＜0.05).There were significant differences in the number of days in hospital,the cost of hospitalization and the incidence of postoperative complications between the two groups(P＜0.01).Conclusion BMI,ASA,nationality,type of analgesia pump,blood transfusion,type of operation and occupation are independent influencing factors for the early postoperative moderate and severe pain;patients with well-controlled postoperative pain had shorter hospitalization days,lower hospitalization expenses and fewer complications.
关键词
疼痛,手术后/镇痛,患者控制/大数据Key words
Pain,postoperative/Analgesia,patient-controlled/Big data引用本文复制引用
出版年
2024
NETL
NSTL
万方数据