护理干预对甲状腺肿瘤手术患者应激反应的影响

Effect of Nursing Intervention on Stress Response in Patients Undergoing Thyroid Cancer Surgery

目的探讨护理干预对甲状腺肿瘤手术患者应激反应的影响。方法将132例甲状腺肿瘤手术患者随机分为试验组和对照组,每组66例。对照组采用常规护理;试验组在常规护理基础上采用术前、术中和术后护理干预。观察2组患者干预前后焦虑抑郁情况﹑术中疼痛情况、术中手术体位耐受情况及术后头痛、呕吐发生率。结果经过护理干预后试验组患者焦虑抑郁评分较干预前均有明显的降低(P<0.01),对照组无明显变化(P>0.05)。术中总疼痛率试验组为7.6%,对照组为65.1%,2组相比差异有统计学意义(P<0.01)。试验组术中体位耐受差比例及术后头痛、呕吐发生率与对照组比较均明显降低,2组相比差异均有统计学意义(P<0.05)。结论护理干预可缓解甲状腺肿瘤手术患者焦虑抑郁情绪,减轻术中疼痛,预防或减轻患者术后头晕、头痛、呕吐、腰背痛等不适,提高患者术后舒适度,使患者更好地适应和配合手术,利于术后康复,是一项切实可行的护理模式。

Objective To investigate the effect of nursing intervention on stress response in patients undergoing thyroid cancer surgery.Methods A total of 132 patients undergoing thyroid cancer surgery were randomly assigned to receive routine care alone（control group,n=66） or in combination with preoperative,intraoperative and postoperative nursing intervention（experimental group,n=66）.States of anxiety and depression,intraoperative pain,orthostatic tolerance,and incidences of postoperative headache and vomiting were observed in both groups.Results The anxiety and depression was significantly reduced by nursing intervention（P0.01）,but was not improved by routine care alone（P0.05）.Compared with control group,nursing intervention significantly decreased the total pain rate（7.6% vs 65.1%,P0.01）,as well as the percentage of patients with poor orthostatic tolerance and incidences of postoperative headache and vomiting（P0.05）.Conclusion Nursing intervention,as a practical model of care,can alleviate anxiety and depression,decrease intraoperative pain,prevent or reduce postoperative dizziness,headache,vomiting and low back pain,improve patient comfort,help patients adapt better to surgery,and is conducive to postoperative rehabilitation.