心理支持对行腹腔镜下肝脓肿切开引流术患者自我感受负担的影响

Effects of Psychological Support on Self-perceived Burden in Patients Undergoing Laparoscopic Incision and Drainage of Liver Abscess

目的：探讨心理支持对行腹腔镜下肝脓肿切开引流术患者自我感受负担的影响。方法：选取于我院行腹腔镜下肝脓肿切开引流术的122例患者为受试对象,按照随机数表分为支持组与对照组各61例。对照组患者仅实施肝胆外科常规护理干预,支持组患者则在其基础上予以心理支持进行干预。比较术前1d、术前1h、术后3d时,两组患者自我感受负担[自我感受负担量表（SPB）]、其陪护家属心理负担[照顾者负担问卷（CBI）]、生命体征[平均动脉压（MAP）、心率（HR）]变化,观察两组患者围术期基本情况（手术时间、高热消除时间、引流时间、住院时间）及术后3d时肝脓肿认识情况异同,分析术后2周时两组患者治疗效果及2周内并发症发生情况差异。结果：术前1h时,支持组患者MAP水平、HR水平、SPB评分及其陪护家属CBI评分均与术前1d时比较无统计学意义（P均〉0.05）,但明显低于同期对照组（t=-3.310,-3.439,-2.536,-2.861;P〈0.05）;术后3d时,支持组患者上述指标均较术前1d时有显著下降,且明显低于同期对照组（t=-2.982,-2.889,-6.413,-4.280;P〈0.05）。支持组患者手术时间、高热消除时间、引流时间、住院时间均明显短于对照组（t=-2.258,-2.284,-3.006,-3.050;P〈0.05）。术后3d时,支持组患者肝脓肿各方面认识明确率均明显高于对照组（χ^2=4.659,7.290,6.100;P〈0.05）。术后2周时,支持组患者治疗有效率明显高于对照组（χ^2=4.319;P〈0.05）。术后2周内,支持组患者并发症发生率明显低于对照组（χ^2=5.536;P〈0.05）。结论：心理支持可有效控制腹腔镜下肝脓肿切开引流术患者围术期自我感受负担,且术后负担明显减轻,对预后疾病转归有利。

Objective：To explore the effects of psychological support on self-perceived burden in patients with laparoscopic incision and drainage of liver abscess.Methods：A total of 122 cases of patients treated with laparoscopic incision and drainage of liver abscess in our hospital were selected for the study and they were divided into the support group（n=61）and the control group（n=61）according to the random number table method.The control group was only given the routine nursing intervention of hepatobiliary surgery,and the support group was given the psychological support intervention on this basis.The self-perceived burden（SPB）,the psychological burden of caregivers family[caregiver burden inventory（CBI）],and the vital signs[mean arterial pressure（MAP）and heart rate（HR）]of the two groups were compared at 1 dand 1 hbefore operation and at 3 dafter operation.The basic perioperative situation（operative time,hyperthermia elimination time,drainage time,hospital stay）and the cognition of liver abscess at 3 d after operation were observed in the two groups,and the treatment effect at 2 weeks after operation and the complications occurrence within 2 weeks were analyzed.Results：At 1 hbefore operation,the levels of MAP and HR,and the SPB score and CBI score of caregivers family were not significantly different from those at 1 dbefore operation in the support group（P〈0.05）,but the indexes were significantly lower than those in the control group at the same time period（t=-3.310,-3.439,-2.536,-2.861;P〈0.05）.At 3 dafter operation,the above indexes in the support group were significantly decreased compared with those at 1 dbefore operation and were significantly lower than those in the control group at the same time period（t=-2.982,-2.889,-6.413,-4.280;P〈0.05）.The operative time,hyperthermia elimination time,drainage time and hospital stay in the support group were significantly shorter than those in the control group（t=-2.258,-2.284,-3.006,-3.050;P〈0.05）.At 3 dafter operation,the recognition rates of liver abscess from all respects in the support group were significantly higher than those in the control group（χ^2=4.659,7.290,6.100;P〈0.05）.At 2 weeks after operation,the effective rate of treatment in the support group was significantly higher than that in the control group（χ^2=4.319,P〈0.05）.Within 2 weeks after operation,the incidence rate of complication in the support group was significantly lower than that in the control group（χ^2=5.536,P〈0.05）.Conclusion：Psychological support can effectively control the perioperative self-perceived burden in patients with laparoscopic incision and drainage of liver abscess,and it can relieve the postoperative burden and benefit the disease prognosis.