个体化心理干预对前列腺电切手术患者心理状况的影响

Effect of individualized psychological intervention on patients after resection of the prostate

目的探讨个体化心理干预在前列腺电切手术患者中的应用效果。方法将188例良性前列腺增生(benign prostate hyperplasia,BPH)患者随机分为实验组和对照组,每组各94例。对照组采用常规护理方法,实验组在常规护理基础上接受个体化心理干预。应用症状自评量表分别在患者入院后第1d、术前第1d、术后第2d和出院当天进行评定。观察两组患者入院后第1d、术前第1d血压及心率,术中失血量、电切综合征、膀胱痉挛、暂时性尿失禁发生率,术后1个月观察患者国际前列腺症状评分(IPSS)、生活质量评分(QOL)、平均尿流率(AFR),手术时间、术后留置尿管时间、住院时间情况。结果心理干预后实验组与对照组比较,总症状指数明显降低(P<0.05),术前血压、心率均较对照组稳定(P<0.05);实验组术后膀胱痉挛发生率较对照组明显减少(P<0.05);手术时间、术中出血量、术后留置尿管时间、电切综合征、暂时性尿失禁发生率、住院时间及术后1个月IPSS、QOL、AFR与对照组比较,差异无统计学意义(均P>0.05)。结论对行前列腺电切手术患者实施个体化心理干预能有效改善患者术前及术后的负性情绪,并能够降低术后膀胱痉挛的发生率。

Objective To assess the use of individualized psychological intervention on patients before and after transurethral plasma kinetic resection of the prostate. Methods A total of 188 patients with benign prostatic hyperplasia were randomly divided into two groups： the control group where patients received conventional nursing, and the experiment group where patients were offered individualized psychological intervention. SCL-90 was used to assess patients on the day of admission, the day before operation, the first day after operation and the day of discharge from hospital. Patients in the two groups were observed on BP and HR on admission and the first day of preoperation; operative bleeding, TURS, cystospasm and temporary urinary incontinence; IPSS, QOL and AFR one month after operation; the time of operation, postoperative catheterization and postoperative hospitalization. Results The total symptom index of the experiment group after intervention was significantly reduced compared with that before intervention and that of the control group （P 〈 0.05）. The HP and HR of the experiment group of preoperation were more stabilized compared with those of the control group （P 〈 0.05）. The cystospasm incidence of experiment group was significantly reduced compared with the control group （P 〈 0.05）. The operative time, operative bleeding, postoperative catheterization, TURS, temporary urinary incontinence, postoperative hospitalization and the IPSS, QOL, AFR one month after operation had no significant difference with the control group（P 〉 0.05）. Conclusion The individualized psychological intervention can effectively improve negative emotion and ease psychological symptoms of patients before and after transurethral plasma kinetic resection of the prostate, and reduce the incidence of the postoperative cystospasm.