规范性护理对脑胶质瘤患者围手术期应激反应的影响

Effect of normative nursing on glioma patients' perioperative period stress reaction

目的观察规范性护理对脑胶质瘤患者围手术期应激反应的影响效果。方法选择2012年7月至2014年7月间收治的316例脑胶质瘤患者,采用随机数字表法分为观察组和对照组,每组各158例,观察组患者给予规范性护理措施,对照组患者给予常规护理干预措施。比较不同时间点两组患者心率(HR)与平均动脉压(MAP)变化情况、应激指标以及心理学指标变化情况。结果与对照组比较,T1、T2点观察组患者的HR降低明显,而MAP升高明显(均P>0.05);T1、T3、T4时间点观察组患者的皮质醇(Cor)、促肾上腺皮质激素(ACTH)、内皮素-1(ET-1)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)和C反应蛋白(CRP)均低于对照组(均P<0.05);T1、T5时间点观察组患者的焦虑自评量表(SAS)评分均低于对照组(均P<0.05)。组内比较,与T0比较,T1、T2、T3点对照组患者的HR明显增加,而MAP明显降低(均P<0.05);与T1比较,T3、T4时间点对照组患者的Cor、ACTH、ET-1、TNF-α、IL-6和CRP均明显升高(均P<0.05)。结论脑胶质瘤患者均出现围手术期应激反应,规范性护理措施可较好地调控应激反应的水平,维持机体内环境的稳定,减缓患者焦虑情绪。

Objective To observe the effect of normative nursing on glioma patients＇ perioperative period stress reaction. Methods We selected 316 cases glioma patients who were treated in our hospital from 2012 July to 2014 July randomly divided them into observation group and control group by random num- ber table method, 158 cases in each group, observation group adopted normative nursing measures, control group patients adopted usual care intervention measures. We compared two group patients＇ heart rate （HR）, mean arterial pressure （MAP） changes, stress index and psychological index changes at different time point. Results Compared with control group, observation group patients＇ HR obviously decreased at T1, T2 time point, but MAP obviously increased ; at T1, T3, T4 time point, observation group patients＇ cortisol （ Cot）, adrenocorticotropic hormone （ACTH） , endothelin-1 （ ET-1 ） , tumor necrosis factor （ TNF-α）, interleukin-6 （IL-6） and C reactive protein （CRP） all obviously decreased （ P 〈 0. 05 ） ; at T1, T5 time point, observation group patients＇ self rating anxiety scale （SAS） scores all obviously decreased （P 〈 0.05 ）. Compared within group, compared with TO, control group patients＇ HR obviously increased at T1, T2 and T3 time point, however MAP obviously decreased （ P 〈 0. 05 ） ; compared with TI, control group patients＇ Cor, ACTH, ET-I, TNF-ct, IL-6 and CRP all obviously increased at T3, T4 time point （ P 〈 0.05 ）. Conclusions Glioma patients all appeared perioperative period stress reaction, normative nursing measures can relatively better regulate and control stress reaction level, maintain organism internal environ- ment stabilization, retard patients＇ anxiety.