知情同意对冠脉搭桥患者术前焦虑和术后康复的影响

Impact of informed consent on preoperative anxiety and postoperative rehabilitation of the patients with coronary artery bypass grafting

目的:探讨手术签字对冠脉搭桥患者术前焦虑及术后康复的影响。方法:将68例拟行冠脉搭桥的患者随机分为实验组35例和对照组33例,实验组由患者参加术前谈话并亲自签署手术同意书,对照组由家属参加术前谈话并签署手术同意书。测定签字前后患者的心率、血压、焦虑程度及术后身体恢复有关指标。结果:实验组签字后患者的血压、心率、焦虑程度和术后疼痛均高于对照组(P<0.05),术后首次下床活动时间延迟,活动耐受时间缩短(P<0.01)。结论:签署知情同意可使搭桥患者的焦虑程度增加,不利于术后康复,应加强围术期患者的心理干预和宣教。

Objective： To investigate the impact of signing signature on preoperative anxiety and postoperative rehabilitation of the patients with coronary artery bypass grafting（CABG）.Methods： 68 patients scheduled for coronary artery bypass grafting were randomly divided into experimental group（n=35） and control group（n=33）.The patients in the experimental group were asked to have a conversation and sign a signature on the operation informed consent paper in person before surgery and in the control group the conversation was held between patients＇ family members and doctors and family members signed a signature instead of the patients.Heart rate,blood pressure,anxiety and postoperative recovery indicators were determined before and after the signing.Results： The blood pressure,heart rate,anxiety and postoperative pain were higher,faster and much in the experimental group than those in the control group after the signing（P〈0.05）;the time of first ambulation and tolerance of activity were delayed and shortened after surgery（P〈0.01）.Conclusion： Signing the operation informed consent paper by patients themselves may increase their anxiety and is not unfavorable to the postoperative rehabilitation,so psychological intervention and health education should be strengthened in the perioperative period.