耳穴贴压对子宫肌瘤腹腔镜手术患者机体应激状态的影响

Effect of auricular compression on the stress state in patients with uterine fibroids laparoscopic surgery

目的观察耳穴贴压对子宫肌瘤腹腔镜手术患者机体应激状态的影响。方法将符合纳入标准的300例子宫肌瘤腹腔镜手术患者随机分为干预组和安慰组,各150例。两组均接受常规术前护理,术前1日8时干预组和安慰组均取穴神门、皮质下、心,干预组给予耳穴王不留行籽贴,安慰组给予与耳穴王不留行籽贴大小、外观相同,但无王不留行籽的海绵软球胶布。采用特质焦虑量表(STAI)和焦虑自评量表(SAS)评估患者心理应激状态;测量患者心率(HR)、血压(BP)及血浆皮质醇(COL)生理应激状态指标。手术当日8时患者送入手术室平静10 min后,再次评估患者心理应激状态并测定生理应激状态指标。结果两组患者年龄、病程、STAI和SAS评分、HR、BP、COL的基线资料比较,差异无统计学意义(P>0.05);干预组干预后STAI评分、SAS评分、SBP和HR明显低于安慰组,差异有统计学意义(P<0.05),而且干预组干预后的COL水平明显低于安慰组,差异有统计学意义(P<0.05)。干预组脱落11例,安慰组脱落13例。脱落原因为各种因素导致的手术取消。结论术前1 d对患者实施耳穴贴压疗法可减轻患者的焦虑,降低心理应激水平,同时也可以改善患者机体应激状态的生理反应,增强面临手术时机体的适应能力,为患者的围手术期身心康复奠定良好的基础。

Objective To observe the effect of auricular compression on the stress state in patients with uterine fibroids laparoscopic surgery. Methods A total of 300 patients with uterine fibroids laparoseopic surgery who met the inclusion criteria were randomly divided into intervention group and placebo group, with 150 cases in each group. Both groups received routine preoperative nursing. At 08：00 on day 1 before surgery, the acupoints including shenmen, below the cortex and heart were taken. The intervention group was given vaccaria seed plaster ear pressure. The placebo group was given sponge soft rubber tape without vaccaria seed while with the same size and the same look. The trait anxiety scale （STAI） and anxiety serf-rating scale （SAS） were used to evaluate the psychological stress status. The physiological stress indicators including heart rate （HR）, blood pressure （BP） and plasma cortisol （COL） were measured. At 08：00 on the day of operation, patients were admitted to the operating room. After calming for 10 minutes, the psychological stress and physical stress status indicators were re-evaluated. Results There were no significant differences in baseline data including age, course of disease, STAI and SAS score, HR, BP and COL between the two groups（P〉0.05）. The STAI score, SAS scoes,SBP and HR in intervention group were significantly lower than those in placebo group after intervention, and the difference was significant（P〈0.05）. The level of COL in intervention group was significantly lower than that in placebo group after intervention, and the differences were significant（P〈0.05）. There were 11 cases of shedding in the intervention group and 13 cases of shedding in the placebo group. The reason for shedding was surgery cancellation caused by various factors to cancel the operation. Conclusion Auricular compression therapy applied in patients on the preoperative day 1. At the same time, it can also improve the physiological response of the patient＇s stress state and enhance the ability of the body to face the operation. The therapy lays a good foundation for perioperative physical and mental rehabilitation