心理干预对围手术期椎管内麻醉患者的作用(1)
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【中图分类号】R614.4；R472.3；R395.1 【文献标识码】A 【文章编号】1003-8183-(2011)09-0032-02
【摘要】目的：观察心理干预对围手术期椎管内麻醉患者的影响。方法：随机选择欲实施椎管内麻醉的手术患者95例，美国麻醉医师协会(ASA)病情评估I-Ⅱ级。将患者随机分为实验组和对照组，实验组46例，对照组49例。实验组的患者在其手术前、手术中和手术后进行心理干预，对照组仅实施常规围手术期护理；术后72h完成焦虑自评量表(SAS)测评及自编效果评分表的评分。结果：实施心理干预后，实验组患者围手术期的情绪稳定，血压、脉搏正常，术后止痛效果满意，肠蠕动恢复及下床活动时间较对照组显著提前。结论：心理干预能减轻椎管内麻醉患者围手术期的应激反应，促进患者术后恢复。
【关键词】围手术期；心理干预；椎管内麻醉
Influence of Mental Intervention on Periooperative Patients Undergoing Intraspinal Anesthesia
Cao Ping
【Abstract】Objective：To observe the influence of mental intervention on periooperative patients undergoing intraspinal anesthesia. Methods： Ninety-five patients with American Society of Anesthesiologists (ASA) grade I -II were randomly selected for intraspinal anesthesia， and then were randomly assigned into the experiment (n=46) and control group (n=49)， the former received preoperative， intraoperative and postoperative mental interventions， while the latter was treated with conventionally periooperative nursing alone. And self-rating anxiety scale (SAS) and self-made effect score scale were used for evaluating the psychological status of the patients 72h after treatment. Results： After mental intervention， the emotion of all patients in the experiment group was stable with blood pressure， pulse within normal range during operation and satisfactory analgesic effect postoperatively， and also the recovery of intestinal peristaltic movements and out-of-bed activity preceded as compared with the control group. Conclusion： Mental intervention can alleviate stress reaction of periooperative patients undergoing intraspinal anesthesia and facilitate their recovery.
【Key words】 Periooperative； Mental intervention； Intraspinal anesthesia
心理干预是指在心理理论的指导下，对个体和群体的心理健康问题和行为施加策略性影响，使之发生指性向预期目标的变化。为了测定心理干预对围手术期椎管内麻醉患者的影响程度[1-6]，我们采取了以下的方法。
1 对象与方法
1.1 对象选择：从欲实施椎管内麻醉的患者中随机抽取95例，美国麻醉医师协会(ASA)病情评估I-II级，男性51例，女性44例，最大年龄63岁，最小32岁。平均47岁。其中阑尾切除术14例，前列腺摘除术12例，子宫次全切除术9例，胆总管结石摘除术11例，小肠切除术和大肠癌切除术各10例，胆囊摘除术13例，胃大部切除术16例。手术前、手术中及手术后患者均为清醒状态，随机分为实验组46例和对照组49例，两组在性别、年龄、文化程度、职业分布、疾病种类间比较等均具有可比性，无显著性差异，P>0.05 。
1.2 方法：两组椎管内麻醉患者手术前各项准备、手术中穿刺技术及护理、手术后处理均按常规操作进行，其中实验组在手术前、手术中及手术后72 h内采取下列干预措施。
1.2.1 对患者进行健康指导：给患者讲解手术的名称、目的、过程麻醉方法及有关手术中和手术后的不适和应对方法 ......
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