正念减压法干预对脑肿瘤患者术前焦虑水平及术后谵妄的影响

Effect of mindfulness-based stress reduction on preoperative anxiety and postoperative delirium in patients with brain tumors

目的分析脑肿瘤患者术后谵妄的发生情况,探讨正念减压法干预对脑肿瘤患者术前焦虑程度及术后谵妄发生率的影响。方法收集2022年12月~2023年3月于哈尔滨医科大学附属第一医院神经外科行择期脑肿瘤切除术的90例患者,采用随机数字表法分为对照组和试验组,每组45例。对照组患者入院后采用常规术前护理,试验组在常规护理的基础上施行正念减压法干预。比较两组患者术前焦虑程度、术中相关指标、术后谵妄发生率及住院时间。结果试验组患者术前1天的焦虑自评量表(self-rating anxiety scale,SAS)评分显著低于对照组(P<0.05);两组患者的手术时间、总失血量、总输液量及术中尿量差异无统计学意义(P>0.05);试验组患者术后3天内的谵妄发生率显著低于对照组(P<0.05);试验组患者总住院时间较对照组显著缩短(P<0.05)。结论术前应用正念减压法干预能够显著降低脑肿瘤患者术前的焦虑程度,并降低术后谵妄的发生率,是提高脑肿瘤患者临床预后的潜在策略。

Objective To analyze the occurrence of postoperative delirium in patients with brain tumor,and to explore the influence of mindfulness-based stress reduction on preoperative anxiety and postoperative delirium in patients with brain tumor.Methods A total of 90 patients who underwent elective brain tumor resection in the Department of Neurosurgery of the First Affiliated Hospital of Harbin Medical University from December 2022 to March 2023 were collected and divided into control group and experimental group by random number table method,with 45 cases in each group.The control group received routine preoperative nursing after admission,and the experimental group received mindfulness-based stress reduction intervention on the basis of routine nursing.Preoperative anxiety,intraoperative indexes,postoperative delirium incidence and hospital stay were compared between the two groups.Results The selfrating anxiety scale(SAS)scores of experimental group 1 day before surgery were significantly lower than those of control group(P<0.05);There was no significan difference in operation time,total blood loss,total infusion volume,and intraoperative urine volume between the two groups(P>0.05);The incidence of delirium 3 days after operation in experimental group was significantly lower than that in control group(P<0.05);The total length of hospital stay in experimental group was significantly shorter than that in control group(P<0.05).Conclusion Preoperative application of mindfulness-based stress reduction can significantly reduce the anxiety level of patients with brain tumor before surgery and reduce the incidence of postoperative delirium,which is a potential strategy to improve the clinical prognosis of patients with brain tumor.