综合心理干预对甲状腺围术期情绪及应激水平的影响

Effects of the comprehensive psychological intervention on emotion and surgical stress during peri-operative period of thyroidectomy

目的:探讨心理干预对甲状腺围手术期情绪以及应激反应水平的影响。方法:选择择期甲状腺手术患者64例随机分为研究组和对照组各32例。入院后即对研究组患者给予综合心理干预至术后7 d。于入院后24 h、术前2 h、术后7 d发放综合医院焦虑抑郁量表(HAD)测查患者情绪状况;于入院后24 h、术前2 h、术后3 d抽取静脉血,检测血液中性粒细胞比率以及血糖、皮质醇、肾上腺素浓度值;出院前发放患者满意度调查问卷。对以上结果进行统计学分析。结果:入院后研究组和对照组HADA、HADD分值无统计学差异(t=0.68、0.79,P>0.05),实施干预后术前2 h以及术后7 d研究组和对照组的HADA、HADD评分有统计学差异(P<0.05或P<0.01),表现为研究组评分小于对照组。入院后未经干预研究组与对照组血清中性粒细胞、血糖、血清皮质醇、肾上腺素浓度无明显差别(t=0.35、0.51、0.63、1.02,P>0.05),经过综合心理干预后术前2 h、术后3 d检测各项指标浓度均有统计学差异(P<0.05或P<0.01),研究组浓度小于对照组。研究组满意度高于对照组(t=3.68,P<0.01)。结论:心理干预能有效改善甲状腺手术患者情绪状况,降低血清应激激素水平,提高患者满意度。

Objective： To explore effects of the comprehensive psychological intervention on emotion and surgical stress during peri-operative period of thyroidectomy. Methods： Patients undergoing selective thyroidectomy were randomly divided into psychological intervention（n =32） group and control（n =32） group. Interventions were given to the patients in group I by providing comprehensive psychological intervention. All patients were drew blood to detect the concentrations of the neutrophile granulocyte, blood sugar, blood cortisol and epinephrine at 24 h after admission preoperative 2 h and 3 days of post-operation. The scale of HAD were evaluated at 24 h after admission, preoperative 2 h and 7 days of post-operation.The patients were given satisfaction questionnaires then the results were analyzed. Results： The two groups were no difference（t=0.68, 0.79,P〉0.05） in the scores of HADA and HADD, but there were differences（P〉0.05 or 0.01） at preoperative 2 h and 7 days of postoperation,the scores of HADA and HADD in group C were higher than those in group I. There were on differences（t=0.35, 0.51, 0.63, 1.02,P〉0.05） in concentrations of the neutrophile granulocyte, blood sugar, blood cortisol and epinephrine in two groups,but differences were found（P〈0.05 or 〈0.01） at preoperative 2 h and 3 days of post operation and the concentrations of group C were higher than those of group I. Patient satisfaction of group I was higher than group C. Conclusion：Psychological intervention can improve the patient＇s emotions more effectively, reduce stress reaction and enhance patients＇ satisfaction.