行为和心理干预对全子宫切除患者术后的影响

Effects of behavioral and psychological intervention on patients after hysterectomy

目的探讨行为干预、心理干预对子宫切除术后患者康复进程的作用。方法选择2005年2月至2008年8月在旬阳县中医院妇科确诊为子宫肌瘤并接受子宫切除手术的患者80例，随机分为对照纽和观察组各40例；对观察组的干预措施为有系统、有计划、有针对性的心理指导和早期康复训练，分别于手术后5～7天、出院后1个月、2个月时访视患者并填写问卷。结果全子宫切除术后部分患者存在卵巢功能减退症状以及排泄功能紊乱症状。两组患者出院后1个月和2个月时，除潮热汗出症状外，观察组患者伤口疼痛、疲乏、烦躁、便秘发生率与对照组比较均有显著性差异（1个月时：χ2值分别为4．528、4．266、6．373、5．165，均P〈0．05；2个月时：χ2值分别为4．588、4．013、5．230、3．914，均P〈0．05）。结论行为、心理干预可以提高患者自我保健的知识和技能，改善心理状况，从而加速患者术后的康复进程。

Objective To explore the effect of behavioral intervention and psychological intervention on rehabilitation of patients after hysterectomy. Methods From February 2005 to August 2008, 80 patients diagnosed with benign uterine myoma and accepting hysterectomy operation in gynecology department of Xunyang County Traditional Chinese Medicine Hospital were randomly divided into control group and observation group with 40 cases in each. Interventions given to observation group included systematic, planned and targeted psychological guidance and early rehabilitation training. Patients were visited and asked to fill questionnaires on 5-7 days after operation, 1 month and 2 months after leaving hospital. Results After hysterectomy some patients suffered ovarian dysfunction symptoms as well as excretion dysfunction symptoms. One month and 2 months after leaving hospital, there were significant differences in incidence rates of wound pain, fatigue, dysphoria and constipation except symptoms of hectic fever and sweat between two groups （ 1 month： A/z value was 4. 528, 4. 266, 6. 373 and 5. 165, respectively, all P 〈 0.05 ; 2 months ： χ2value was 4.588,4.013, 5. 230 and 3. 914, respectively, all P 〈 0.05 ）. Conclusion Behavioral and psychological intervention can improve self-care knowledge and skills of patients and improve the psychological condition, so that the postoperative rehabilitation is accelerated.