妇科手术患者及其亲属联合接受音乐认知治疗对患者术后疼痛的影响

Effects of Music Combined with Cognitive Therapy on the Pain of Patients and Their Relatives after Gynecological Surgery

目的观察妇科手术患者及其亲属联合接受音乐认知治疗对患者术后疼痛的影响。方法将60例于椎管内麻醉下行全子宫切除术患者及其60例亲属随机分成两组。音乐组亲属于术前接受音乐和认知治疗,患者于术中听音乐;对照组不进行干预。于干预前、术前和术后24h均采用Zung焦虑自评量表对亲属进行评估,于术前、术后0h和2h检测患者血清皮质醇;记录术后24h平均疼痛视觉模拟评分(VAS)和镇痛药用量。结果音乐组亲属术前和术后的焦虑评分低于对照组(F1,17=31.688,P<0.01);音乐组患者术后的皮质醇水平(F1,17=5.356,P=0.033)和镇痛药用量(F1,17=8.402,P<0.01)低于对照组。结论椎管内麻醉下妇科手术患者及其亲属联合接受音乐认知治疗,可有效降低亲属的焦虑,并持续缓解患者的术后疼痛。

Objectives To investigate the effects of music combined with cognitive therapy in patients and their relatives on pain after gynecological surgery.Methods Sixty patients scheduled for hysterectomy and their relatives were randomly divided into two groups.In the music group,the relatives received music and cognitive therapy twice before the operation,and the patients received music during the operation.The control group received no interven-tion.The anxiety level of the relatives was evaluated before intervention,before and 24 h after surgery by Zung Self-Rating Anxiety Scale.The serum cortisol levels of the patients were detected before,0 h and 2 h after operation.The pain scores（VAS）at rest and the analgesic amount were recorded from 0 to 24 h every 2 hours after operation.Results The anxiety score of music group was lower than that of the control group（F1,17=31.688,P〈0.01）.The patients of music group had less cortisol concentration（F1,17=5.356,P=0.033）and 24 h analgesic amount（F1,17=8.402,P〈0.01）than those of the control group.Conclusions Music combined with cognitive therapy in patients and their relatives may have a perfect anxiolytic effect on the relatives and along-term analgesic effect on the pa-tients after gynecological surgery.