认知护理对甲状腺瘤手术患者应激反应的影响

Influence of cognitive nursing on patients＇ stress reaction to surgery for thyroid cancer

目的探讨认知护理对甲状腺瘤手术患者应激反应的影响。方法将128例甲状腺瘤手术患者随机分为干预组66例和对照组62例。干预组在术前给予认知护理措施干预，对照组术前只给予常规护理，术前1d采用焦虑自评量表（SAS）和抑郁自评量表（SDS）评定两组患者的心理状况，分别于手术麻醉前30min测量两组患者血压、脉搏的变化，测定两组患者皮质醇及血管紧张素Ⅱ的水平变化，并进行比较。结果干预组焦虑值和抑郁值均明显低于对照组，干预组手术麻醉前30min血压明显较对照组低，脉搏也明显慢于对照组，干预组手术麻醉前30min皮质醇及血管紧张素Ⅱ也明显较对照组低，两组比较，差异均有统计学意义（P均〈0．01）。结论认知护理可明显消除甲状腺瘤手术患者不良心理状态，减轻患者的应激反应程度，增强患者治疗的信心，从而促进康复。

Objective To explore the influence of cognitive nursing on patients＇ stress reaction to surgery for thyroid cancer. Methods 128 patients undergoing thyroid cancer surgery were randomly divided into intervention group （n = 66） and control group （n = 66）. The intervention group was given cognitive nursing, while the control group normal nursing. The psychological status of both groups was evaluated by using Self- Rating Anxiety Scale （SAS） and Self-Rating Depression Scale （SDS） 1 day before the operation. Blood pressure, pulse, cortisol and angiotensin Ⅱ of both groups were measured 30 minutes before anesthesia and their results were compared. Results The scores of SAS and SDS of the intervention group were obviously lower than those of the control group. Blood pressure, the level of cortisol and angiotensin Ⅱ in the intervention group were obviously lower than those in the control group 30 minutes before anesthesia; pulse in the intervention group was slower than that in the control group （P 〈 0. 01 ）. Conclusions Cognitive nursing could remove poor psychological emotion of patients undergoing thyroid cancer surgery, mitigate their stress reaction and enhance their contidence to combat against the disease so as to promote their rehabilitation.