心理行为干预对军人患者术后早期认知功能障碍的影响

Effects of psycho-behavioral intervention on early postoperative cognitive dysfunction of young army patients

目的探讨心理行为干预对青年军人患者术后早期认知功能障碍的影响。方法选择拟行下腹部手术的现役军人患者50例,年龄18-44岁,ASA分级Ⅰ-Ⅱ级。将患者随机分为干预组和对照组,每组25例。术前1 d,干预组进行心理行为干预,而对照组只作常规术前探视。两组于术前1 d和术后1 d,分别进行神经心理学量表数字广度测验、数字符号测验、Stroop测验、中文听觉词汇学习测验,测定认知功能,采用Z计分法判断术后认知功能障碍发生率。结果术后认知功能障碍发生率对照组为20%（5/25）,干预组为4%（1/25）;与对照组比较,干预组术后认知功能障碍发生率下降（P〈0.05）。结论心理行为干预能较好地减少青年军人患者术后早期认知功能障碍的发生率,有利于患者术后康复。

Objective To observe the effects of psycho-behavioral intervention on the early postoperative cognitive dysfunction of young army patients. Methods Total 50 in-service young army patients to be provided with lower abdomen operation（ aged 18-44,ASA Grade Ⅰ to Ⅱ） were selected and divided randomly into intervention and control groups（ n = 25,respectively）. The intervention group was provided with psycho-behavioral interventions one day before the operation,while the control group was only provided with routine preoperative visiting. One day before and after the operation,neuro-psychological scalogram digit-span tests,digit symbols tests,Stroop tests and auditory Chinese verbal learning tests were carried out in both groups,respectively for the identification of the cognitive functions of the patients,and then their incidence rate of dysfunctions was determined by Z-score method. Results The incidence rate of postoperative dysfunctions in the control group was 20%（ 5 /25）,while the intervention group was 4%（ 1 /25）. The incidence rate of postoperative dysfunctions of the intervention group was lower than that of the control group（ P〈 0. 05）. Conclusion Psychobehavioral interventions can well reduce the incidence rate of the early postoperative cognitive dysfunction of young army patient and is helpful to patient＇s postoperative rehabilitation.