心理护理对老年腹腔镜胆囊切除术患者的影响

Effects of Psychological Nursing on Elderly Patients with Laparoscopic Cholecystectomy

目的：观察心理护理对老年腹腔镜胆囊切除术（LC）患者的影响。方法：选取2013年1月至2017年3月我院收治的300例老年LC患者,按信封法随机分为对照组和观察组,每组150例。对照组给予常规护理,观察组在对照组基础上加用心理护理干预,分别于护理前后采用焦虑自评量表（SAS）、抑郁自评量表（SDS）评价患者焦虑、抑郁情绪;比较两组手术时间、术中出血量、术中血压与心率水平、术后疼痛视觉模拟评分（VAS）、肠鸣音恢复时间、首次肛门排气时间、首次排便时间、住院时间及护理满意度。结果：护理前,两组SAS评分、SDS评分比较无显著差异（t=0.431,1.086;P〉0.05）;护理后,观察组较对照组SAS评分、SDS评分均明显降低（t=-3.745,-3.887;P〈0.001）。观察组较对照组手术时间、术中出血量均明显减少（t=-3.142,-4.902;P〈0.01）,术中舒张压及心率水平均明显降低（t=-3.549,-4.205;P〈0.05）。观察组术后1d、2d、3d的疼痛VAS评分均明显低于对照组（t=-2.498,-4.230,-9.662;P〈0.01）。观察组肠鸣音恢复时间、首次肛门排气时间、首次排便时间及住院时间均明显短于对照组（t=-6.416,-5.233,-6.266,-8.323;P〈0.001）。观察组护理满意度明显高于对照组（χ2=26.136,P〈0.001）。结论：心理护理对老年LC患者有很大的影响,能够减轻手术应激,促进术后快速康复,在临床上对老年LC患者开展心理护理更具有实用性。

Objective：To observe the effects of psychological nursing on elderly patients with laparoscopic cholecystectomy（LC）.Methods：A total of 300 cases of elderly LC patients treated in our hospital from January 2013 to March 2017 were selected and randomly divided into the control group and the observation group（each n=150）by the Envelope method.The control group was given the routine nursing,and the observation group was additionally given the psychological nursing intervention on the basis of the control group.The anxiety and depression were evaluated by self-rating anxiety scale（SAS）and self-rating depression scale（SDS）before and after nursing,and the operative time,intraoperative blood loss,intraoperative blood pressure and heart rate,postoperative visual analogue scale（VAS）,bowel sounds recovery time,first anal exhaust time,first defecation time,hospital stay and nursing satisfaction were compared between the two groups.Results：There were no significant differences in the SAS and SDS scores between the two groups before nursing（P〉0.05）.After treatment,the SAS score and SDS score of the observation group were significantly lower than those of the control group（t=-3.745,-3.887;P〈0.001）.The operative time and the intraoperative blood loss in the observation group were significantly lower than those in the control group（t=-3.142,-4.902;P〈0.01）,and the intraoperative diastolic blood pressure and heart rate were significantly lower in the observation group（t=-3.549,-4.205;P〈0.05）.The pain VAS score at 1 d,2 dand 3 dafter operation in the observation group were significantly lower than those in the control group（t=-2.498,-4.230,-9.662;P〈0.01）.The bowel sounds recovery time,the first anal exhaust time,the first defecation and hospital stay in the observation group were significantly shorter than those in the control group（t=-6.416,-5.233,-6.266,-8.323;P〈0.001）.The nursing satisfaction in the observation group was significantly higher than that in the control group（χ2=26.136,P〈0.001）.Conclusion：Psychological nursing has a great impact for elderly LC patients,and can reduce the surgical stress and promote rapid postoperative rehabilitation,and it is practical to have clinical psychological nursing for elderly LC patients.