子宫肌瘤患者围麻醉期心理干预对麻醉期间应激反应的影响

Effect of psychological intervention during anesthetic stage on perioperative stress of patients with uterine myoma

目的探讨围麻醉期心理干预对子宫肌瘤患者焦虑、抑郁程度和应激反应的影响。方法选择硬腰联合麻醉下腹式全子宫切除术的子宫肌瘤患者60例,完全随机法分为心理干预组(30例)和对照组(30例)。对照组行常规子宫全切除术准备,心理干预组在常规子宫全切除术准备的基础上进行心理干预。分别测评入院第2天晨7∶40(T1)、手术前1d晨7∶40(T2)、麻醉满意切皮时(T3)、手术结束时(T4)和术后第2天晨7∶40(T5)的SAS和SDS评分、心率和血清皮质醇浓度。结果对照组在T2、T3、T4和T5时间点的SAS和SDS评分高于心理干预组(P<0.05)。与T1时间点相比,两组患者的HR虽然都有所升高,但心理干预组明显低于对照组(P<0.05),这表明心理干预组患者围麻醉期HR较平稳。与T1时间点相比,两组患者的血清皮质醇浓度虽然都有所升高,但心理干预组低于对照组(P<0.05),且T4时间点最高。结论围麻醉期心理干预能明显降低子宫肌瘤患者麻醉期间的焦虑、抑郁水平和应激反应。

Objective To explore the effect of psychological intervention during anesthetic stage on perioperative stress of patients with uterine myoma. Methods Adult female patients with uterine myoma randomly divided into intervention（n=30） group and control（n = 30） group. In control group, patients received regular nursing. In intervention group, patients received psychological intervention during anesthetic stage. Interventions were given to the intervention group by providing psychological support, health education and relaxing training. The SAS and SDS score were recorded. The heart rate（HR） and blood serum cortisol concentration were also detected. Results The SAS,SDS score, HR and blood serum cortisol concentration were not statistically significant at sequenti luce morning after hospital admission. But after interventions,these index in control group were significantly higher than intervention group. The heart rate in intervention group were significantly stable than control group. Conclusion Psychological intervention can reduce the level of anxiety depression and surgical stress in the patients with uterine myoma.