减少尿路透镜术后的阿片类药物使用,而不损害患者的结果,在全州质量改善协作中
Wilson Sui1, Suprita Krishna1, Russell Becker2
1University of Michigan, Ann Arbor, MI, USA.
Urology
|January 15, 2026
概括
由于MUSIC ROCKS倡议,尿路透镜术后的术后阿片类药物使用显著减少. 患者报告的结果是相似的,无论患者在出院时接受了阿片类药物还是需要救援药物,支持多式联络疼痛管理.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 疼痛管理 疼痛管理
- 医疗保健服务研究 医疗服务研究
背景情况:
- 密歇根泌尿外科改善协作 (MUSIC) 减少结石 (ROCKS) 导致的手术并发症的倡议旨在减少尿路透镜术后的术后阿片类药物使用.
- 减少阿片类药物依赖是术后护理的一个关键目标.
研究的目的:
- 评估MUSIC ROCKS倡议对患者报告的治疗结果 (PROs) 的影响,即尿路透镜术后减少术后阿片类药物使用.
- 为了比较阿片类药物和非阿片类药物使用者之间的疼痛强度和干扰,在尿道透视后进行尿道透视.
主要方法:
- 来自MUSIC ROCKS倡议的患者评估,包括完整的处方和PRO数据.
- 使用多变量回归模型对PROMIS疼痛强度和干扰得分进行比较.
- 部分分析比较了需要救援阿片类药物的阿片类药物使用者与被释放的阿片类药物使用者.
主要成果:
- 尿道镜检查后的阿片类药物处方率从83% (2016) 降至13% (2023).
- 在未使用过阿片类药物的患者中,23%的患者在手术后7-10天使用了阿片类药物,经历了更严重的疼痛强度和干扰.
- 在服用阿片类药物出院的患者与需要救援阿片类药物的患者之间没有发现显著的PRO差异.
结论:
- 在密歇根州,尿管透视后的阿片类药物使用量大幅下降.
- 释放无阿片类药物的患者,后来需要救援阿片类药物,显示了与阿片类药物释放的患者相似的PRO,支持多式联络治疗.
- 手术后使用支架是疼痛的重要预测因素,表明改善结果的可修改因素.
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