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| 脑功能状态仪疼痛指数在患者术后疼痛评估中的应用 |
| Application of brain function state instrument pain index in the assessment of postoperative pain |
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| DOI：10.12089/jca.2019.07.009 |
| 中文关键词: 疼痛评估 视觉模拟评分法 疼痛指数 |
| 英文关键词: Assessment of pain Visual analogue scale Pain index |
| 基金项目:上海市嘉定区卫生和计划生育委员会青年科研项目（2017-QN-01）；上海交通大学医学院附属瑞金医院北院研究基金项目（2016ZY09）；云南省迪庆州科技计划-创新发展计划沪滇合作项目（2018AA002） |
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| 中文摘要: |
目的 研究脑功能状态仪疼痛指数（PI）在术后患者疼痛评估价值和应用。
方法 选择2016年5月至2018年9月本院骨科四肢创伤患者200例，男114例，女86例，年龄23~63岁，BMI 20~25 kg/m2，ASA Ⅰ或Ⅱ级。分别采用脑功能状态仪疼痛指数（PI）和视觉模拟评分法（VAS评分）对患者术后2、6、24和48 h疼痛进行评分，并记录不同疼痛程度患者的例数。比较两种方法的评分时间、分析两者评价的一致性。
结果 脑功能状态仪PI评估患者疼痛所需的评分时间为（2.36±0.67）min，VAS评分评估患者疼痛所需的评分时间（2.24±0.59）min，差异无统计学意义，但PI可以连续评估患者的疼痛，评估不可主观交流的患者疼痛。PI与VAS评分在术后2、6、24和48 h疼痛评分加权Kappa分析显示具有一致性，其中术后2 h两者的一致性Kappa值最高。
结论 脑功能状态仪PI与VAS评分对患者术后疼痛的评分具有较高的一致性。PI可以有效评估患者在各种状态下的疼痛程度，有利于临床镇痛工作的开展。 |
| 英文摘要: |
Objective To investigate the value and application of pain index (PI) using cerebral state monitor for the assessment of postoperative pain.
Methods A total of 200 patients with limb trauma, from May 2016 to September 2018, including 114 males and 86 females, aged 23 - 63 years, with BMI 20 - 25 kg/m2 and ASA physical status Ⅰ or Ⅱ. PI and visual analogue scale (VAS) were used to respectively grade the postoperative pain at 2, 6, 24 and 48 h, and the number of patients with different degrees of pain was recorded. We compared the evaluation time and analyzed the consistency between the two methods.
Results The pain assessment with PI took (2.36 ± 0.67) min. As for VAS, the evaluation time was (2.24 ± 0.59) min. There was no significant difference in evaluation time between the two methods. But PI is available for continuous pain assessment and patients who can't subjectively describe their pain. Weighted Kappa analysis of PI and VAS at 2, 6, 24 and 48 h after operation showed good consistency, and the highest Kappa values were found at 2 h after operation.
Conclusion PI and VAS have high consistency in the evaluation of postoperative pain. PI can effectively evaluate the pain degree of patients in various states, which is conducive to the development of clinical analgesia work. |
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