心理护理对逆行胰胆管造影患者围手术期心理障碍的干预效果

The intervention effect of psychological nursing on the perioperative abnormal psychology patients treated with endoscopic retrograde cholangiopancreatography

目的：探讨内镜下逆行胰胆管造影（ERCP）患者围手术期精神心理特征,评价心理护理对ERCP患者围手术期心理障碍的干预作用,为制定ERCP患者围手术期心理护理方案提供科学依据。方法：将58例ERCP患者随机分为干预组30例和对照组28例,另选取24名健康者作为健康对照（健康组）。干预组和对照组分别于术前及术后采用综合医院焦虑/抑郁情绪测定量表（HAD）、匹兹堡睡眠质量指数（PSQI）量表进行测评,并比较2组术后卧床时间和住院时间。健康组仅作心理状况评估。结果：ERCP组患者术前抑郁和焦虑评分均高于健康组（P〈0.01和P〈0.05）;术前PSQI评分中,除催眠药物和日间功能障碍评分差异均无统计学意义外,其他各项评分均高于健康组（P〈0.05~P〈0.01）。干预组与对照组术前HAD和PSQI评分差异均无统计学意义（P〉0.05）。术后,干预组焦虑及抑郁评分均低于对照组（P〈0.05和P〈0.01）;PSQI评分除催眠药物、日间功能障碍因子评分与对照组差异均无统计学意义（P〉0.05）外,其余各项评分差异均有统计学意义（P〈0.05~P〈0.01）。干预组术后卧床时间和住院时间均短于对照组（P〈0.05）。结论：行ERCP患者围手术期表现出焦虑、抑郁和睡眠障碍,心理护理可改善ERCP患者的心理障碍,并缩短卧床时间及住院时间。

Objective： To explore the psychological characteristics of the perioperative patients treated with endoscopic retrograde eholangiopancreatography（ERCP）, evaluate the intervention effects of psychological nursing on the ERCP patients for providing scientific basis in formulating psychological nursing program. Methods：Fifty-eight patients treated with ERCP were randomly divided into the intervention group（30 cases） and control group（28 cases）, and 24 healthy people were set as the healthy control group. The intervention group and control group were evaluated using the Hospital Anxiety and Depression Scale （HAD） and Pittsburgh Sleep quality index scale（PSQI） before and after operation, the bed time and hospital stay after ERCP between the intervention group and control group were compared. The psychological status of healthy control group were evaluated. Results：The preoperative anxiety and depression scores in intervention group and control group were higher than those in healthy control group（ P 〈 0.05 and P 〈 0.01 ）. Among the preoperative PSQI scores, the differences of the scores of hypnotic drugs and daytime dysfunction between the intervention group and control group were not statistically significant（ P 〉 0.05 ） ,and other item scores in intervention group and control group were higher than those in healthy control group （P 〈 0.05 to P 〈 0.01 ）. The differences of the preoperative scores of HAD and PSQI between the intervention group and control group were not statistically significant（ P 〉 0.05 ）. The postoperative anxiety and depression scores in intervention group were lower than those in control group（ P 〈 0.05 and P 〈 0.01 ）. Except the scores difference of hypnotic drugs and daytime dysfunction,other item scores differences of PSQI scores between the intervention group and control group were statistically significant（ P 〈 0.05 to P〈 0.01 ）. The postoperative bed time and hospital stay in intervention group were shorter than those in control group（ P 〈 0.05 ）. Conclusions ：The anxiety,depression and sleep disturbance are the main perioperative manifestations. Psychological nursing can significantly improve the psychological stress, reduce bed time and hospitalization time of patients.