以音乐治疗为核心的系统化护理在重症肺炎患者中的应用及临床价值

Application and clinical value of systematic nursing based on music therapy in patients with severe pneumonia

目的探讨音乐治疗为核心的系统化护理在重症肺炎患者中的应用及临床价值。方法选取浙江医院ICU2016年1月—2017年1月收治的重症肺炎患者120例,按随机数字表法分为对照组(64例)和观察组(56例)。对照组采用传统应用的常规护理方法;观察组采用以音乐治疗为核心的系统化护理干预方法,即给患者施行音乐治疗为核心,播放不同的音乐使患者处于一种放松的状态。比较2组患者的心理状态、夜间睡眠质量,并比较分析2组患者的免疫水平和炎症因子变化状况。结果护理后观察组焦虑自评量表(self-rating anxiety scale,SAS)评分、匹兹堡睡眠质量指数量表(pittsburgh sleep quality index,PSQI)评分分别为(39.83±5.24)分、(9.52±1.89)分,显著低于对照组的(47.46±5.69)分、(10.21±2.36)分,差异有统计学意义(均P<0.05);观察组患者CD4^+CD25^+Treg细胞[(2.79±1.23)%]和CD8^+CD28^-Treg细胞[(6.76±4.27)%]显著高于对照组[(2.21±0.98)%和(4.54±2.66)%],而TNF-α[(62.32±10.48)ng/L]和IL-10[(37.56±13.43)ng/L]表达水平显著低于对照组[(71.51±11.78)ng/L和(59.32±16.91)ng/L],差异有统计学意义(均P<0.05)。结论以音乐治疗为核心的系统化护理可以改善患者心理状况、睡眠质量,降低炎症因子水平,改善患者机体的炎症反应状态。

Objective To discuss the application and clinical value of systematic nursing based on music therapy in pa- tients with severe pneumonia. Methods A total of 120 patients with severe pneumonia were selected and randomly divided into the observation group and the control group, with 60 cases in each group. The control group was given routine nursing measures. The observation group received systematic nursing intervention on the basis of routine nursing measures, i.e. providing the patients with music therapy and playing different music to relax them. The mental state and night sleeping quality of both groups were compared and the immune level and inflammatory factors were analyzed. Results The scores of SAS （39.83 ±5.24） and PSQI （ 9.52± 1.89） in the observation group were significantly lower than the control group （47.46 ±5.69） and （10.21 ± 2.36）, the differences were statistically significant（ all P 〈 0.05）. The levels of CD4＋ CD25＋ Treg cell （2.79 ± 1.23 ） % and CD8＋ CD28 - Treg cell （ 6.76 ± 4.27 ） % in the observation group were significantly higher than the control group （2.21 ±0.98）% and （4.54 ±2.66）%, and the levels of TNF-α（62.32 ±10.48）ng/L and IL-10 （37.56 ±13.43 ）ng/L in the observation group were significantly lower than the control group （71.51 ± 11.78 ）ng/L and （59.32± 16.91 ） ng/L, the differences were statistically significant （ all P 〈 0.05 ）. Conclusion Systematic nursing based on music therapy can significantly improve the mental state and sleep quality of patients with severe pneumonia, in addition to lowering inflammatory factors, thus improving inflammatory reaction in patients.