心理护理临床路径对显微血管减压术后功能延迟恢复患者的影响

Effects of Clinical Pathway of Psychological Care in Patients with Delayed Functional Recovery after Microvascular Decompression Surgery

目的探讨心理护理临床路径对显微血管减压术后神经功能延迟恢复患者的影响。方法将40例行显微血管减压术术后发生延迟恢复的患者按随机数字表法分为2组:观察组和对照组,每组20例。2组患者均采用常规治疗及常规护理。在此基础上,观察组实施心理护理临床路径。不同入院时间(入院时、入院后3 d、入院后1周)观察组实施心理护理临床路径采用90项症状自评量表(SCL-90)进行评分,采用SCL-90对观察组、对照组入院后1周进行评分,采用Zung抑郁自评量表(SDS)、焦虑自评量表(SAS)对观察组、对照组入院时、入院后1周进行评分。结果入院后1周观察组实施心理护理临床路径SCL-90评分值显著低于入院时及入院后3 d(P<0.01)。观察组入院后1周躯体化、强迫症状、人际关系敏感、抑郁、焦虑、偏执SCL-90评分值均明显低于对照组(P<0.05或P<0.01),观察组入院后1周敌对、恐怖SCL-90评分值与对照组比较差异均无统计学意义(均P>0.05)。观察组入院后1周SDS、SAS评分值均明显低于对照组(均P<0.01),观察组入院后1周SDS、SAS评分值均明显低于入院时(均P<0.01)。结论心理护理临床路径能有效地降低显微血管减压术后功能延迟恢复患者的焦虑、抑郁程度,改善了人际关系,促进患者神经功能的恢复。

Objective To explore the effects of clinical pathway of psychological care in patients with delayed functional recovery after microvascular decompression surgery.Methods Forty patients with delayed functional recovery after microvascular decompression surgery were randomly divided into observation group and control group,with 20 patients in each group.All patients received conventional treatment and care.On this basis,clinical pathway of psychological care was implemented in observation group.Mental health status of patients was assessed by using Symptom Checklist-90（SCL-90） at hospital admission,3 days after admission,and 1 week after admission.Furthermore,symptoms of depression and anxiety were measured by using Zung self-rating depression scale（SDS） and self-rating anxiety scale（SAS） in both groups at admission and 1 week after admission.Results In observation group,SCL-90 score 1 week after admission was significantly lower than that at admission and 3 days after admission（P0.01）.Compared with the control,somatization,obsessive-compulsive symptoms,interpersonal sensitivity,depression,anxiety,and paranoia SCL-90 scales,but not hostility and terror scores,were significantly decreased in observation group 1 week after admission（P0.05 or P0.01）.Moreover,after 1 week of admission,both SAS and SDS scores in observation group were significantly lower than those in control group,and the scores were also lower than those in observation group at admission（all P0.01）.Conclusion Clinical pathway of psychological care can reduce anxiety and depression,improve relationships,and promote neurological recovery in patients with delayed functional recovery after microvascular decompression surgery.