围手术期心理干预对心率变异性及疼痛耐受的影响

The Effects of Psychological Interventions on Heart Rate Variability and Pain Tolerance in the Perioperative Period

目的探讨围手术期心理干预对患者心率变异率(HRV)及疼痛耐受的影响。方法 96例普外科手术治疗患者随机数字表法分为观察组与对照组,每组48例,对照组患者仅给予临床基础护理措施,观察组患者基于对照组进行围手术期心理护理干预,包括个性化心理护理及健康教育,采集两组患者术前24 h中HRV指标,并应用计算机处理获取低频带(LF)、高频带(HF)、总频带(TP)及低、高频带比值(LF/HF)数据指标,术后清醒状态下评估患者的疼痛耐受情况并统计护理满意度。结果术前24 h动态心电图及计算机处理结果显示,观察组患者心率变异频域LF、LF/HF指标明显低于对照组HF及TP明显高于对照组(P<0.05);观察组患者术后6、24 h VAS疼痛评分明显低于对照组,并且护理满意度明显高于对照组(P<0.05)。结论围手术期进行心理干预可使患者保持平衡状态,从而减轻术后疼痛程度,可有效降低围手术期应激反应发生率,具有临床应用及推广价值。

Objective To study the effects of psychological interventions on heart rate variability （ HRV） and pain tolerance in the perioperative period.Methods The 96 patients by general sur-gery operation were randomly divided into observation group and control group, 48 cases in each group.The control group was only given the basic nursing measures and the control group was for the psychological nursing interventions of perioperative period based on the control group, including personalized psychological care and health education.We would collect the HRV indexof the two groups 24hbeforeoperation and obtain low frequency band （ LF） , high fre-quency band （HF）, the total frequency band （TP） and low, high frequency band ratio （LF/HF） data indicators by the computer processing .Thepain tolerance of and nursing satisfaction state would be assessed and counted during awake period after surgery.Results According to the dynamic electrocardiogram and computer processing results 24h before operation, the HRV frequency domain LF and LF/HF indexes in the observation group were significantly lower than those in the control group, but the HF and the TP indexes were significantly higher than thosein the control group （ P〈0.05 ） .The VAS pain scores in the observation group were significantly lower than those in control group6h and 24h after operation , but the degree of nursing satisfac-tion was significantly higher than that of the control group （P〈0.05）.Conclusions Perioperative psychological interventions can make patients to maintain the state of equilibrium, lessen the degree of postoperative pain andreduce the incidence of perioperative stress reaction.It has clinicalvalue of application and popularization.