246所医院住院患者自控镇痛护理现状的调查研究

doi:10.3761/j.issn.0254-1769.2026.12.015

中华护理杂志 ›› 2026, Vol. 61 ›› Issue (12): 1695-1703.DOI: 10.3761/j.issn.0254-1769.2026.12.015

246所医院住院患者自控镇痛护理现状的调查研究

周雁荣¹(), 张海燕²^,^*(), 汪晖¹, 何苗², 杜玫洁¹, 曾莹¹, 王秀丽²

¹ 华中科技大学同济医学院附属同济医院护理部武汉市 430030
² 北京大学人民医院护理部北京市 100044

收稿日期:2025-10-11 出版日期:2026-06-20 发布日期:2026-06-12
*通讯作者: 张海燕，E-mail：zhanghaiyan@pkuph.edu.cn
作者简介:周雁荣：女，本科，主任护师，总护士长，E-mail：1002406585@qq.com
第一联系人：作者贡献声明
周雁荣：实施研究、数据整理及分析、论文撰写及修改、基金支持；何苗、杜玫洁、曾莹、王秀丽：实施研究、数据整理及分析、论文撰写；张海燕、汪晖：研究指导、论文修改
基金资助:
2023年同济医院科研基金护理专项重点项目(2023C09)

Investigation of the current status of patient-controlled analgesia nursing practice in hospitalized patients across 246 hospitals

ZHOU Yanrong¹(), ZHANG Haiyan²^,^*(), WANG Hui¹, HE Miao², DU Meijie¹, ZENG Ying¹, WANG Xiuli²

¹ Department of Nursing， Tongji Hospital，Tongji Medical College，Huazhong University of Science and Technology， Wuhan 430030， China
² Department of Nursing， Peking University People’s Hospital， Beijing 100044， China

Received:2025-10-11 Online:2026-06-20 Published:2026-06-12
* Corresponding author: ZHANG Haiyan，E-mail：zhanghaiyan@pkuph.edu.cn
Funding program:
Key Project of Nursing Special Program，2023 Tongji Hospital Research Fund(2023C09)

摘要/Abstract

摘要：

目的调查住院患者自控镇痛（patient-controlled analgesia，PCA）的护理现状，为进一步规范PCA管理及实践提供依据。方法采用便利抽样法，于2025年5月使用自制问卷，对31个省（自治区、直辖市）中开展PCA的二级和三级医院护士进行调查。结果共回收有效问卷4 675份，有效问卷回收率为96.33%。83.21%的护士所在医院或科室已建立PCA护理规范或流程；69.43%的护士所在医院或科室设有PCA管理多学科团队；70.76%的护士所在医院开展了PCA护理质量控制。在PCA临床护理实践中，静脉自控镇痛使用最普遍（95.42%），PCA主要用于术后镇痛（92.32%）；麻醉科医生是使用前评估（70.14%）、泵安装（74.20%）与维护（60.64%）的主要人员；急性、慢性疼痛的首选评估时机分别为疼痛改变或发生不良反应时（73.39%）、每班评估（68.11%），镇痛效果主要采用疼痛主观评估法评估（91.51%）；80.60%的护士所在科室要求书写PCA相关记录；92.75%的护士对患者进行健康教育。PCA主要护理实践问题为患者评估不充分或不准确（61.69%）、镇痛效果评价不全面（61.24%）等，PCA护理实践的主要障碍因素为PCA护理规范、标准或流程缺失（68.81%）、PCA相关知识缺乏（66.18%）等。结论国内PCA护理管理体系已初步建立，但在多学科协作、质量控制及全流程评估等方面有待完善，护士的实践能力需进一步加强。

关键词: 疼痛, 患者自控镇痛, 护理, 现状调查

Abstract:

Objective To investigate the current status of patient-controlled analgesia（PCA） nursing practices in China and provide a basis for developing standardized PCA nursing procedures. Methods A cross-sectional survey was conducted in May 2025 using a convenience sampling method. A self-designed questionnaire was administered to nurses working in secondary and tertiary hospitals providing PCA services across 31 provinces（autonomous regions and municipalities）. Results A total of 4 675 nurses participated，resulting in a valid response rate of 96.33%. Among them，83.21% reported that their hospitals or departments had established PCA nursing protocols or procedures；69.43% indicated the presence of a PCA multidisciplinary team；70.76% confirmed that PCA nursing quality control was implemented. Regarding clinical application，intravenous PCA was the most commonly used （95.42%），primarily for postoperative pain management（92.32%）. Anesthesiologists were the main personnel responsible for pre-use assessment（70.14%），pump installation（74.20%），and maintenance（60.64%）. The preferred assessment timing for acute pain was “when pain changed or adverse reactions occurred”（73.39%），“shift-based assessment”（68.11%）. Subjective assessment tools remained the primary method for evaluating analgesic efficacy （91.51%）. Documentation of PCA care was required in 80.60% of the departments，and 92.75% of nurses provided patient health education. Major practical issues included insufficient patient assessment（61.69%） and incomplete evaluation of analgesic effects（61.24%）. Key barriers were the lack of standardized protocols/guidelines/procedures （68.81%） and insufficient related knowledge among nurses（66.18%）. Conclusion While PCA nursing protocols have been preliminarily established in Chinese hospitals，multidisciplinary collaboration，quality control，and comprehensive process assessment require further improvement. Nurses’ PCA-related competencies also need further strengthening.

Key words: Pain, Patient Controlled Analgesia, Nursing Care, Current Status Investigation

周雁荣, 张海燕, 汪晖, 何苗, 杜玫洁, 曾莹, 王秀丽. 246所医院住院患者自控镇痛护理现状的调查研究[J]. 中华护理杂志, 2026, 61(12): 1695-1703.

ZHOU Yanrong, ZHANG Haiyan, WANG Hui, HE Miao, DU Meijie, ZENG Ying, WANG Xiuli. Investigation of the current status of patient-controlled analgesia nursing practice in hospitalized patients across 246 hospitals[J]. Chinese Journal of Nursing, 2026, 61(12): 1695-1703.

图/表 5

表1 调查对象所在地区的分布情况（n=4 675）

Table 1 Regional distribution of hospitals participating in the survey（n=4 675）

表2 调查对象的一般资料（n=4 675）

Table 2 General information of survey subjects（n=4 675）

表3 不同级别医院住院患者自控镇痛护理规范或流程的主要内容比较[名（百分比，%）]

Table 3 Comparison of the main content of patient-controlled analgesia nursing standards or procedures across different hospital levels[cases（percentage，%）]

表4 患者自控镇痛使用前评估、泵安装与维护人员（n=4 675）

Table 4 Personnel arrangement for patient-controlled analgesia assessment，pump installation，and maintenance before use（n=4 675）

表5 患者自控镇痛使用过程中的护理评估内容与时机（n=4 675）

Table 5 Nursing assessment content and timing during patient-controlled analgesia use（n=4 675）

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246所医院住院患者自控镇痛护理现状的调查研究

Investigation of the current status of patient-controlled analgesia nursing practice in hospitalized patients across 246 hospitals

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