个性化心理护理对儿童急性化脓性阑尾炎围手术期应激反应的干预效果

Effect of perioperative psychological nursing on stress response in children with acute suppurative appendicitis

目的探讨儿童急性化脓性阑尾炎围手术期个性化心理护理对应激反应的影响。方法将80例急性化脓性阑尾炎患儿随机分为观察组与对照组,各40例。对照组行常规护理,观察组行常规护理联合个性化心理护理。手术前后测定并比较两组的心率(HR)、收缩压(SBP)、舒张压(DBP)、血清皮质醇(Cor)、去甲肾上腺素(NE)、促肾上腺皮质激素(ACTH)水平和改良耶鲁围手术期焦虑量表(mYPAS)评分,比较两组患儿的康复情况。结果观察组患儿家长满意率为95.00%,显著高于对照组的80.00%(P<0.05);术后观察组的HR、SBP、DBP、血清Cor、NE、ACTH水平及mYPAS评分均显著低于对照组(P<0.05);观察组术后肛门排气时间、首次下床活动时间、啼哭时间及住院时间均较对照组明显缩短(P<0.05)。结论儿童急性化脓性阑尾炎围手术期开展个性化心理护理可减轻术后应激反应,减轻焦虑状态并促进术后康复。

Objective To investigate the effect of perioperative psychological nursing on stress response in children with acute suppurative appendicitis. Methods A total of 80 children with acute suppurative appendicitis were randomly divided into observation group and control group,each group with 40 cases. The control group received routine nursing,observation group received routine nursing combined with perioperative psychological nursing. The parental satisfaction between the two groups were compared. The HR,SBP,DBP and serum levels of Cor,NE,ACTH and scores of mYPAS before and after operation were measured and compared,and the recovery condition of two groups were compared. Results After operation,the HR,SBP,DBP and serum levels of Cor,NE,ACTH and the score of mYPAS in the observation group were significantly lower than those in the control group(P<0.05);The time of anal exhaust,ambulation time,crying time and hospitalization time in the observation group were significantly shorter than those in the control group(P<0.05). Conclusion Individualized psychological nursing for children with acute suppurative appendicitis can reduce the postoperative stress response,reduce the anxiety state and promote postoperative rehabilitation.