肝切除术后疼痛管理策略的构建:证据总结和德尔菲研究
Yuqin Wang1, Xiuxiu Song1, Siqi Wang2
1Department of General Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, People's Republic of China.
Journal of pain research
|January 1, 2025
概括
这项研究开发了一种基于证据的疼痛管理策略,用于肝切除术患者使用德尔菲方法. 由此产生的策略是科学的,适用于改善肝癌患者的术后护理.
科学领域:
- 在瘤学瘤学.
- 手术管理的手术管理.
- 疼痛医学 医学 疼痛医学
背景情况:
- 对肝癌的肝切除术带来了重大的术后疼痛挑战.
- 有效的疼痛管理对于患者的康复和结果至关重要.
- 现有策略需要基于证据的改进.
研究的目的:
- 开发和总结肝癌肝切除术后的最佳疼痛管理策略.
- 通过严格的基于证据的方法,增强现有的疼痛管理协议.
- 通过使用Delphi方法来完善专家共识的策略.
主要方法:
- 基于"6S"证据金字塔模型的系统文献搜索 (搜索到2023年12月).
- 由两名研究人员进行的独立文献选和质量评估.
- 证据整合和初步战略开发,然后是两轮的德尔菲过程来改进.
- 专家共识的统计分析使用有效响应率,权威系数 (Cr) 和肯德尔的W.
主要成果:
- 在证据综合中包括了14项研究.
- 两轮德尔菲进程的结果是一个总结的战略,其中包括13个第一级和48个第二级项目.
- 专家达成了高度的共识,100%的有效响应率和权威系数 (Cr) 为0.832.8的权威系数表明了这一点.
- 专家意见显示了显著的协调 (肯德尔的W值在0.114-0.222,p<0.05之间).
结论:
- 肝切除术后开发的疼痛管理策略在科学上是合理和实用的.
- 该战略已经准备好转化为临床实践.
- 未来的研究将专注于确认实施战略的可行性.
相关概念视频
01:29Chronic Pancreatitis II: Collaborative Care
46
The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
Assessment:
46
01:25Analgesia and Pain Management
390
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
390
01:29Appendicitis-II: Diagnostic Studies and Management
47
Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
47