颅内肿瘤患者术前的放松训练

Preoperative relaxation training of patients with intracranial tumor

目的:了解颅内肿瘤患者术前的心理特征,并观察放松训练对颅内肿瘤患者焦虑程度和生命体征的影响。方法:选择中山大学附属第一医院2004-09/2005-02收治的颅内肿瘤患者102例,采用便利抽样和成组匹配分组法分成放松训练组52例和对照组50例。2组患者入院后均按常规治疗,另外放松训练组还于术前第3天至术晨进行放松训练,包括呼吸训练和渐进性肌肉放松训练,2次/d,30min/次,共进行6次。在入院时和术前采用特质状态焦虑问卷(共40项,20～80分,得分越高,焦虑程度越重)测量2组患者的焦虑程度;放松训练组在实施放松训练前后、对照组在入院时和术前测量血压、心率和呼吸频率。结果:102例患者进入结果分析。①2组患者术前的特质状态焦虑问卷得分均高于入院时,但放松训练组术前和入院时得分差值明显低于对照组(4.83±3.50,9.32±4.33,P<0.001)。②2组患者入院时的血压、心率和呼吸频率比较无差异,术晨较入院时都有升高(P=0.000);但放松训练组术晨血压、心率和呼吸频率均低于对照组(P<0.05),③放松训练组每次训练后的血压、心率和呼吸频率都显著低于训练前(P<0.01)。结论:放松训练能有效减轻颅内肿瘤患者术前的焦虑水平;无论是经过呼吸训练还是放松训练,患者的血压、心率、呼吸较训练前都有明显的降低,且随着训练次数的增加,训练效果有增加的趋势,放松训练对稳定颅内肿瘤患者术前的生命体征有一定的作用,对提高手术与麻醉的安全性有积极的意义。

AIM： To comprehend the preoperative mental profiles of patients with intracranial tumor, and observe effects of relaxation training on anxiety degree and vital signs of those patients. METHODS： Totally 102 patients with intracranial tumor treated in the First Affiliated Hospital of Sun Yat-sen University between September 2004 and February＇2005 were divided into relaxation training group （n=52） and control group （n=50） according to convenience sample and caiegory matching methods. All the patients received routine treatment after hospitalization, and from the third day before operation to the morning of operation day, moreover the patients in training group performed relaxation training comprising respiration training and progressive muscular relaxation training, 30 minutes once and twice a day for totally 6 times. At admission and before operation, the anxiety degrees of patients in beth groups were detected with State-Trait Anxiety Inventory （STAI, including 40 items and scored 20-80 points, the higher score meant the severe anxiety degree）; Blood pressure, heart rate and respiratory frequency were measured in relaxation group before and after relaxation training and in control group at admission and before operation. RESULTS： Totally 102 patients were involved into the result analysis. ① The STAI scores of all the patients were higher before operation than at admission, however, the difference of preoperative score and hospitalization score was significantly lower in relaxation training group than in control group （4.83±3.50, 9.32±4.33, P 〈 0.001）.②The blood pressure, heart rate and respiratory frequency of all the patients demonstrated no difference at admission, but increased on the morning of operation day （P=0.000）, and were significantly lower in relaxation training group than in control group （P 〈 0.05）.③In relaxation training group, the levels of the blood pressure, heart rate and respiratory frequency were remarkably decreased after training （P 〈 0.01）. CONCLUSION： Relaxation training can effectively decreased the anxiety degree of preoperative patients with intracranial tumor, No matter respiration training or relaxation training, the levels of blood pressure, heart rate and respiratory all strikingly reduce after training, and training effects rise along with the increase of training times. Relaxation training is influential for stabilizing vital sighs of preoperative patients with intracranial tumor as well as actively heightening reliability of operation and anesthesia.