生殖医学杂志

目的 探讨医患互动反馈式管理模式在子宫良性疾病患者接受高强度聚焦超声（HIFU）消融治疗围术期疼痛管理中的应用效果。方法 选取2022年8月至2024年12月在北京协和医院HIFU消融手术中心接受HIFU治疗的270例子宫良性疾病患者，应用计算机随机分配法分为研究组与对照组，每组各135例。对照组患者接受常规管理模式，研究组患者采用医患互动反馈式管理模式进行围术期疼痛管理。比较两组术后疼痛评分、镇静药物使用情况、压力评分以及患者满意度。结果 两组患者疾病类型、病灶位置比较均无显著性差异（P>0.05）。术后2h，两组患者间疼痛视觉模拟评分（VAS）无显著性差异（P>0.05）；术后24h，两组患者的VAS评分均较术后2h显著降低（P<0.01），且研究组相对于对照组降幅更显著（P=0.03）。此外，研究组在围术期所使用的镇痛药物剂量、术后2h压力知觉量表评分均显著低于对照组（P<0.05），而出院时患者满意度显著高于对照组（P<0.01）。结论 对接受HIFU治疗的子宫良性疾病患者，实施医患互动反馈式疼痛管理模式，能优化其疼痛管理效果，有效减轻术后疼痛与压力感受，减少镇痛药物的使用，最终提高患者的满意度。

Objective:To investigate the effectiveness of doctor-patient interactive feedback management model in pain management during the perioperative period of high-intensity focused ultrasound(HIFU)treatment for patients with uterine benign diseases.Methods:From August 2022 to December 2024,270 patients with uterine benign diseases who underwent HIFU ablation surgery at Peking Union Medical College Hospital were enrolled and divided into the experimental group and the control group using computer-based random allocation,with 135patients in each group.The patients in the control group received conventional management,while those in the experimental group received perioperative pain management through the doctor-patient interactive feedback management model.The two groups were compared in terms of postoperative pain scores,sedative medication usage,stress scores,and patients' satisfaction.Results:There were no significant differences in disease type and lesion location between the two groups(P>0.05).At 2 hours postoperatively,there was no statistically significant difference in Visual Analog Scale(VAS)pain score between the two groups(P>0.05).At 24 hours postoperatively,the VAS scores of both groups had significantly decreased compared to 2 hours postoperatively(P<0.01),with the decrease being more significant in the experimental group(P=0.03).Additionally,the dosage of analgesic medications used during the perioperative period and the scores on the Perceived Stress Scale at 2 hours postoperatively in the experimental group were significantly lower than those in the control group,with a statistically significant difference(P<0.05).The patient satisfaction on discharge was significantly higher in the experimental group compared to the control group(P<0.01).Conclusions:Implementing a doctor-patient interactive feedback management model for patients with uterine benign diseases undergoing HIFU treatment significantly optimizes pain management outcomes,effectively reduces postoperative pain and stress perception,decreases the use of analgesic medications,and ultimately improves patient satisfaction.