认知行为干预对三镜联合治疗胆道结石患者应激反应的影响

Effect of cognitive behavioral intervention on stress response of patients with biliary calculi treated by three endoscopies combination

目的探讨认知行为干预对三镜联合治疗胆道结石患者应激反应的影响。方法选择我院2017年12月至2018年12月三镜联合治疗的胆道结石患者108例,随机将其等分为对照组和观察组,对照组采用常规护理干预,观察组在对照组基础上采用认知行为干预,比较两组围术期应激反应、并发症发生率。结果两组气腹后10 min的心率(HR)、平均动脉压(MAP)、血糖、去甲肾上腺素(NE)、肾上腺素(E)以及皮质醇均高于手术前,观察组HR,MAP,血糖低于对照组(P<0.05),但组间NE,E及皮质醇比较差异无统计学意义(P>0.05);手术结束时两组以上指标均有所改善,观察组HR,MAP,血糖基本恢复至术前水平,且低于对照组(P<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论认知行为干预应用于三镜联合治疗胆道结石患者中将有利于降低围术期应激反应,减少术后并发症,有利于患者术后康复。

Objective To investigate the effect of cognitive behavioral intervention on stress response of patients with biliary calculi treated by three endoscopies combination.Methods To select 108 cases of patients with biliary calculi treated by three endoscopies combination who admitted to our hospitalfrom December 2017 to December 2018 .They were randomly divided into control group and observation group.The control group was received routine nursing intervention and the observation group was used cognitive behavioral interventions on the basis of the control group.The perioperative stress response and complication rate were compared in the two groups.Results At 10 min after pneumoperitoneum , all of these indicators such as heart rate (HR), mean arterial pressure (MAP), blood glucose, norepinephrine (NE), adrenaline (E), and cortisol in the two groups were higher than those before surgery.The HR, MAP, blood glucose of the observation group were lower than those of the control group(P<0.05), but there was no significant difference in NE, E and cortisol between the two groups( P >0.05).At the end of the operation, these indicators of both groups were improved, the HR, MAP and blood glucose of the observation group were basically restored to the preoperative level ,and the HR, MAP and blood glucose of the observation group were lower than those of the control group(P<0.05).The incidence of complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The cognitive behavioral intervention in patients with biliary calculi treated by three endoscopies combination would help to reduce perioperative stress response, reduce postoperative complications, and facilitate postoperative recovery.