基于医学人文的音乐疗法联合右美托咪定在LC患者快速康复中的应用

Study on the application of music therapy combined with dexmedetomidine in the rapid rehabilitation of LC patients

目的:探讨基于医学人文的音乐疗法联合右美托咪定对腹腔镜胆囊切除术(LC)患者快速康复的影响。方法:选择2020年01月~2020年07月本院择期全麻下行LC手术、预计手术时间1h的胆囊良性疾病患者60例,随机分为两组,每组30例:右美托咪定组(对照组、C组)、音乐疗法+右美托咪定组(试验组、M组)。记录两组术中情况和生命体征;通过焦虑自评量表(SAS)评估焦虑程度、匹茨堡睡眠质量指数量表(PSQI)评估睡眠质量;采用视觉模拟评分法(VAS)评估患者术后疼痛程度。结果:两组患者的ASA分级、性别、年龄、体重指数、麻醉时长、手术时长、输液量、出血量比较差异均无统计学意义。M组的MAP、HR与C组同时间点相比较均明显降低,同时间点的SpO2比较无显著差异性。两组患者术前1天的SAS评分及PSQI评分比较无显著差异性;M组术前25min和术后24h的SAS评分相比同时间点的C组明显降低,M组术后24h的PSQI评分相比同时间点的C组明显降低。M组在出手术室时以及术后8h、24h、48h的VSA评分与C组同时间点相比较均明显降低。结论:基于医学人文的音乐疗法联合右美托咪定可以缓解LC患者围术期焦虑,缓解疼痛,从而促进术后康复。

Objective To explore the effect of music therapy combined with dexmedetomidine on the rapid recovery of laparoscopic cholecystectomy(LC)patients.Methods From January 2020 to July 2020,60 patients with benign gallbladder diseases who underwent LC operation under general anesthesia and expected operation time of 1 hour were randomly divided into two groups,30 cases in each group:dexmedetomidine group(control group,group C),music therapy+dexmedetomidine group(test group,group M).The intraoperative condition and vital signs of the two groups were recorded;the anxiety level was assessed by SAS and the sleep quality was assessed by PSQI;the postoperative pain level was assessed by VAS.Results There was no significant difference in ASA grade,gender,age,BMI,anesthesia time,operation time,infusion volume and bleeding volume between the two groups.Map and HR of group M were significantly lower than those of group C at the same time point,and Sp O2 at the same time point had no significant difference.There was no significant difference between the two groups in SAS score and PSQI score on the first day before operation;the SAS score of 25 minutes before operation and 24 hours after operation in group M was significantly lower than that of group C at the same time point,and the PSQI score of 24 hours after operation in group M was significantly lower than that of group C at the same time point.The VSA score of group M was significantly lower than that of group C at the same time point.Conclusion Music therapy combined with dexmedetomidine based on medical humanities can relieve anxiety and pain of LC patients during perioperative period,and promote postoperative rehabilitation.