主动与被动音乐疗法缓解学龄期儿童包皮环扎术疼痛的效果分析

Effect of active and passive music therapy on alleviating the pain of school-age children with prepuce cerclage

目的 探讨主动与被动音乐疗法对学龄期儿童包皮环扎术疼痛的影响.方法 将89例喜欢音乐的学龄期患儿随机分为干预组与对照组,均局麻下行包皮环扎术,均进行传统的健康教育.对照组患儿术中聆听轻音乐,干预组患儿术中聆听并主动随着音乐吟唱自己喜欢的歌曲.采用VAS视觉模拟尺测评患儿疼痛程度,采用汉密尔顿焦虑量表（HAMA）测评患儿恐惧程度.结果 患儿术中生理指标（血压和心率）干预组均低于对照组,但差异无统计学意义（P＞0.05）.患儿术中VAS疼痛评分干预组为（4.96±1.11）分,低于对照组的（5.84±1.24）分,两组差异有统计学意义（t=-3.559,P＜0.01）.手术前两组HAMA总分差异无统计学意义（P＞0.05）,手术后,干预组HAMA总分为（3.21±0.60）分,低于对照组的（7.20±1.67）分,差异有统计学意义（t=17.87,P＜0.05）;干预组术后HAMA各项评分均低于术前,差异均有统计学意义（P＜0.05）.结论 主动与被动音乐疗法能缓解儿童恐惧心理,降低手术疼痛程度,使患儿在意识清醒情况下积极配合手术.

Objective To＇investigate the effect of active and passive music therapy on alleviating the pain of school-age children with prepuce cerclage. Methods Eighty-nine patients who enjoyed music of school- age children were randomly divided into the intervention group and the control group, and all patients were carried out the prepuce cerelage under local anesthesia and the traditional health education. The control group listened to light music, and the intervention group listened to light music and actively sang their favorite songs during the operation. The degree of pain was assessed by visual analogue scale （ VAS）, and the level of fear was evaluated by Hamilton Anxiety Scale （HAMA）. Results The blood pressure and heart rate in the intervention group were lower than those of the control group during the operation, and the differences were not statistically significant （P 〉0. 05）. The score of VAS was （4. 96 ± 1.11） in the intervention group, which was lower than （5. 84 ± 1.24） in the control group during operation, and the difference was statistically significant （t = -3. 559, P 〈 0. 01 ）. The difference in the total score of HAMA was not statistically significant before operation between two groups （P 〉 0. 05）. The total score of HAMA was （3.21 ± 0. 60） in the intervention group, which was lower than （7. 20 ± 1.67） in the control group after operation, and the difference was statistically significant （t =17.87 ,P 〈0.05）. The anxiety, nervousness, insomnia, fear, cognitive function, depression, mood and total scores in the intervention group after operation were significantly lower than those before operation, and the differences were statistically significant （P 〈 0. 05）. Conclusions The active and passive music therapy can relieve the children＇s fear, decrease the pain degree of operation, and the children can actively cooperate with surgery in conscious condition.