Saur P, Gatzert S, Kettler D
Zentrum Anaesthesiologie, Rettungs- und Intensivmedizin, Georg-August-Universität Göttingen, Deutschland.
Anasthesiol Intensivmed Notfallmed Schmerzther. 2004 Sep;39(9):542-50. doi: 10.1055/s-2004-825885.
It is very important to investigate the patient's disability and pain. Interviews of intubated and tracheotomised patients were neglected because of inadaequate measuring methods. This is the first prospective study that evaluates the disability and pain of intubated and tracheotomised patients.
Disability, Hospital Anxiety and Depression Scale, Visuelle Analogue Scale, Glasgow Coma Scale and structured questions were used to investigate the disability and pain of ventilated patients. 26 patients of an interdisciplinary operative intensive care unit took part in the study. Sociodemographic parameters, ventilation, sedation and pain were evaluated. Doctors and nurses were asked to assess the patient's pain and disability.
17 intubated and 9 tracheotomised patients were included in the study. Mean intensity of pain was 30.3 (SD = 31.4), anxiety 40.8 (SD = 31.4), disability 30.0 (SD = 11.5) and disability caused by ventilation 61.9 (SD = 28.5). 46.2 % of the patients had a pathological subscale of anxiety and 50 % of depression in the Hospital Anxiety and Depression Scale. Nurses assessed the patient's disability and pain better than the doctors.
A high disability has to be taken in account in the therapy of intubated and tracheotomised patients.
调查患者的残疾情况和疼痛状况非常重要。由于测量方法不完善,对插管和气管切开患者的访谈一直被忽视。这是第一项评估插管和气管切开患者残疾情况和疼痛状况的前瞻性研究。
使用残疾评定量表、医院焦虑抑郁量表、视觉模拟评分量表、格拉斯哥昏迷量表和结构化问题来调查通气患者的残疾情况和疼痛状况。一个跨学科手术重症监护病房的26名患者参与了该研究。对社会人口统计学参数、通气、镇静和疼痛进行了评估。要求医生和护士评估患者的疼痛和残疾情况。
该研究纳入了17名插管患者和9名气管切开患者。平均疼痛强度为30.3(标准差=31.4),焦虑程度为40.8(标准差=31.4),残疾程度为30.0(标准差=11.5),通气导致的残疾程度为61.9(标准差=28.5)。在医院焦虑抑郁量表中,46.2%的患者焦虑分量表呈病理性,50%的患者抑郁分量表呈病理性。护士对患者残疾情况和疼痛的评估比医生更好。
在插管和气管切开患者的治疗中必须考虑到高残疾率。