音乐治疗联合舒芬太尼术后静脉镇痛用于肺癌手术患者的临床观察

ROLE OF MUSICAL THERAPY COMBINED WITH SUFENTANIL FOR POSTOPERATIVE INTRAVENOUS ANALGESIA IN PATIENTS UNDERGOING LUNG CANCER RESECTION

目的:观察音乐治疗联合舒芬太尼静脉自控镇痛对肺癌手术后患者焦虑心理、镇痛和血液动力学的影响。方法:择期肺癌手术患者60例,ASAⅠ～Ⅱ级,采用数字表法随机分为二组(n=30):音乐治疗组(M组)和对照组(C组)。M组患者术前接受音乐放松训练15 min,术后3、7、15、19 h分别进行1 h音乐干预。C组患者在同一时间段不采用任何音乐治疗。术后M组与C组患者均接受舒芬太尼静脉术后自控镇痛(postoperative patient-controlled analgesia,PCA)。记录患者术后4、8、12、16、20和24 h患者的焦虑自评量表(self rating anxiety scale,SAS)分值、视觉模拟评分(visual analogue scale,VAS)、收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)和心率(heart rate,HR)变化。记录术后舒芬太尼用量、PCA按压的次数以及不良反应。结果:与C组相比,M组患者术后各时点的SAS评分、VAS评分、SBP、DBP和HR均显著降低(P<0.01),M组的舒芬太尼用量和PCA按压次数明显减少(P<0.01),并且不良反应降低(P<0.01)。结论:音乐治疗联合舒芬太尼静脉自控镇痛用于肺癌手术后患者能够产生更好的镇痛效果,且能缓解患者的焦虑情绪,有效地稳定患者术后早期血流动力学变化并且减少舒芬太尼用量。

Objective： To evaluate the effects of musical therapy combined with sufentanil for postoperative intravenous analgesia on anxiety, analgesic effects and hemodynamics in patients undergoing lung cancer operation. Methods： Sixty patients undergoing lung cancer surgery （ASA Ⅰ-Ⅱ grade） were randomly divided into two groups （n = 30）： musical therapy group （group M） and control group （group C）. The patients of group M received music relaxation training for fifteen minutes before surgery and one hour music intervention at 3, 7, 15, 19 hours after surgery, while the patients of group C were given no music treatment. All patients received sufentanil for patient-controlled analgesia （PCA） pump after operation. The self-rating anxiety scale （SAS） and visual analog scale （VAS）, hemodynamic changes [including systolic blood pressure （SBP）, diastolic blood pressure （DBP）, heart rate （HR）] were measured 4, 8, 12, 16, 20 and 24 hours after operation. The consumption of sufentanil, press time of PCA and side effects were also recorded. Results： Compared with group C, the patients of group M showed decrease of SAS scores, VAS scores, SBP, DBP and HR （P 〈 0~01）. Compared with group C, the patients of group M also had less press time of PCA, postoperative sufentanil consumption and side effects （P 〈 0.01）. Conclusion： Musical therapy combined with sufentanil for postoperative intravenous analgesia could produce better analgesic effects, relief of anxiety, reduction of sufentanil consumption and morestable early postoperative hemodynamic changes in patients undergoing lung cancer operation.