ISSN 2097-6046（网络）
ISSN 2096-7446（印刷）
CN 10-1655/R
主管：中国科学技术协会
主办：中华护理学会
中华急危重症护理杂志

中华急危重症护理杂志 ›› 2026, Vol. 7 ›› Issue (3): 365-372.doi: 10.3761/j.issn.2096-7446.2026.03.020

• 证据综合研究 • 上一篇    下一篇

心脏外科手术患者围手术期非药物疼痛管理的最佳证据总结

黄昉芳1(), 姜云龙2, 刘胜楠2, 周燕1, 胡俊1, 卫建华3,*()   

  1. 1 浙江大学医学院附属第一医院综合监护室 杭州市 311121
    2 浙江大学医学院附属第一医院护理部 杭州市 311121
    3 浙江大学医学院附属第一医院外科监护室 杭州市 310006
  • 收稿日期:2025-06-16 出版日期:2026-03-10 发布日期:2026-03-02
  • 通讯作者: 卫建华 E-mail:1372200696@qq.com;1188029@zju.edu.cn
  • 作者简介:黄昉芳：女，本科，副主任护师，护士长，E-mail：1372200696@qq.com
  • 基金资助:
    浙江省医药卫生科技计划项目(2022KY746)

Summary of the best evidence on non-pharmacological pain management in the perioperative period for patients undergoing cardiac surgery

HUANG Fangfang1(), JIANG Yunlong2, LIU Shengnan2, ZHOU Yan1, HU Jun1, WEI Jianhua3,*()   

  1. 1 Comprehensive Intensive Care Unit， the First Affiliated Hospital of Zhejiang University School of Medicine， Hangzhou 311121， China
    2 Nursing Department， the First Affiliated Hospital of Zhejiang University School of Medicine， Hangzhou 311121， China
    3 Surgical Intensive Care Unit， the First Affiliated Hospital of Zhejiang University School of Medicine， Hangzhou 310006， China
  • Received:2025-06-16 Online:2026-03-10 Published:2026-03-02
  • Contact: WEI Jianhua E-mail:1372200696@qq.com;1188029@zju.edu.cn
  • Supported by:
    Zhejiang Provincial Medical and Health Science and Technology Plan Project(2022KY746)

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摘要：

目的 评价ICU心脏外科患者围手术期非药物疼痛管理的相关证据，为临床疼痛管理实践提供参考。方法 确定循证问题，制订检索策略，计算机检索国内外专业指南网、协会网及数据库内有关心脏外科患者非药物疼痛管理的指南、证据总结、最佳实践信息册、推荐实践、系统评价及原始研究。由循证小组对纳入文献进行质量评价、证据提取和总结。结果 最终纳入文献22篇，综合为10个维度的证据，分别是建立跨学科合作团队、非药物疼痛管理教育、疼痛评估工具、疼痛管理目标、非药物疼痛管理的实施原则、非药物疼痛管理的介入时机、术前非药物疼痛管理、术中非药物疼痛管理、术后非药物疼痛管理、干预过程监测与管理，共37条证据。结论 心脏外科围手术期患者非药物疼痛管理对于减少乃至暂停镇痛药物的使用具有重要意义，临床护士可根据患者的疼痛程度及镇痛药物的戒断过程等制订个体化非药物疼痛干预策略，形成药物镇痛到非药物疼痛管理的范式转移。

关键词: 心脏外科, 围手术期, 非药物疼痛管理, 证据总结, 循证护理学

Abstract:

Objective To evaluate evidence on non-pharmacological pain management for ICU cardiac surgery patients during the perioperative period，providing references for clinical pain management practice.Methods We identified evidence-based questions，developed retrieval strategies，and conducted computer searches of guidelines，evidence summaries，best practices，recommended practices，systematic reviews，and original research related to non-pharmacological pain management for cardiac surgery patients on professional guidance websites，association websites，and databases both domestically and internationally. The evidence-based team conducted quality evaluation，evidence extraction，and summary of the included literature.Results Twenty-two studies were included，synthesized into 10 dimensions with 37 pieces of evidence，covering interdisciplinary team building，non-pharmacological pain management education，pain assessment tools，management goals，implementation principles，intervention timing，preoperative management，intraoperative management，postoperative management，and process monitoring.Conclusion Non pharmacological pain management for perioperative patients in cardiac surgery is of great significance in reducing or even suspending the use of analgesics. Clinical nurses should develop indivi-dualized non-pharmacological pain intervention strategies based on pain intensity and withdrawal process of analge-sics，forming a paradigm shift from pharmacological pain management to non-pharmacological pain management.

Key words: Cardiac Surgery, Perioperative Period, Non-Pharmacological Pain Management, Summary of Evidence, Evidence-Based Nursing