摘要
目的应用重症监护疼痛观察工具（CPOT）评估重症监护室（ICU）内行机械通气老年患者的疼痛指标，以选择正确的镇静镇痛方案。方法将110例行神经外科手术后入住ICU的老年患者分为3个评估阶段，每个阶段包括2个测评点，共6个测评点（T1～T6）。第1阶段（插管无意识期，T1～T2），第2阶段（插管有意识期，T3～T4），第3阶段（拔管有意识期，T5～T6）；T1、T3和T5是每个阶段患者非伤害性刺激测评点，T2、T4和T6是伤害性刺激测评点。每个观测点的评估时间持续1min。在第2和第3阶段各测评点观测后，要求患者应用疼痛强度标尺（PIDS）进行疼痛的自我测评并记录。记录患者T1～T6的CPOT值、心率和平均动脉压（MAP）。结果在3个阶段中，每个阶段的伤害性刺激测评点T2、T4和T6的CPOT（26．8和0．54，3．36和1．20，2．78和0．68）分、MAP（95和85，94和82，94和84）mmHg和心率（95和85，95和87，94和87）次／min均高于非伤害性刺激测评点T1（t=-42．89，-55．95，-55．38）、T3（t=-5．54，-9．95，-11．33）和T5（t=-5．52，-11．33，-11．78）（P〈0．05）。在第2和第3阶段中，T4和T6的PIDS值均高于T3和T5点（2．52和1．69，2．12和1．44）分（P％0．05）。第2阶段CPOT和PIDS值在T3和T4点的相关系数分别为0．49和0．58（P〈0．05），第3阶段CPOT和PIDS值在T5和T6点的相关系数分别为0．52和0．59（P〈0．05），分别达到中等程度相关。结论CPOT是目前对机械通气老年患者进行疼痛测定的有效手段。
Objective To assess the degree of pain in elderly patients with mechanical ventilation in ICU using critical-care pain observation tool（CPOT） and to choose the correct sedative and analgesic method. Methods 110 elderly patients in ICU after neurosurgery were divided into three assessment stages, every stage had two record points and total six points （T1-T6）： the first stage （intuhation and unconsciousness, T1-T2）, the second stage （intubation and consciousness, T3- T4 ） and the third stage（extubation and consciousness, T5-T6 ）. Among them T1, T3 and T5 were nonnocuity assessment points of every stage, while T2, T4 and T6 were nocuity assessment points of every stage. The assessment time was one minute at every point. After recorded at every point in second and third stages, patients were asked to use the pain intensity descriptive scale （PIDS） themselves. CPOT, heart rate and mean arterial pressure （MAP） from T1 to T6 were recorded as well as PIDS from T3 to T6 in second and third stages. Results In the three stages, CPOT（（26.8 vs. 0. 54, 3.36 vs. 1.20, 2.78 vs. 0.68） scores], HR[（95 vs. 85, 94 vs. 82, 94 vs. 84）beat/min] and MAP[（95 vs. 85, 95 vs. 87, 94 vs. 87）mm Hg] at T2 , T4and T6 were higher than T1 （t=-42.89,-55.95,-55.38）, T3 （t=-5.52,-11.33,-11.78）and T5 （t=-5. 54,-9. 95,-11. 33） （P〈0.05）. The PIDS at T4and T6were higher than at T3 and T6 in the second and third stages （（2.52 vs. 1.69, 2.12 vs. 1.44） scores] （P〈0.05）. The correlation coefficient between CPOT and PIDS at Ta and T4 in the second stage were 0.49 and 0.58, respectively （P〈0.05）, and between CPOT and PIDS at T5 and T6 were
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2011年第12期1008-1011,共4页
Chinese Journal of Geriatrics
