耳穴贴压联合个性化音乐疗法对初产妇围手术期应激反应的影响

Effect of auricular-point pressure combined with personalized music therapy on perioperative stress response in primipara

目的:探讨耳穴贴压联合个性化音乐疗法对初产妇围手术期应激反应的影响。方法:选取择期进行剖宫产的初产妇1000例随机分为观察组和对照组,每组500例。两组均于术前1 h和术后3、6、12 h及24 h分别给予个性化音乐放松干预1 h,在此基础上,观察组选取皮质下、神门、心、子宫、卵巢及内生殖器耳穴进行贴压,每次每穴按压1 min,每15 min重复1次,每次用力从轻到重,以耳郭有发胀、发酸和放射感为度。观察两组初产妇焦虑自评量表评分、视觉模拟量表评分,心率、收缩压、促甲状腺激素、皮质醇与血糖水平。结果:最终共973例初产妇完成本次研究,其中观察组488例、对照组485例。进入手术室前两组初产妇焦虑自评量表评分均较入组时明显改善(P<0.05),且观察组优于对照组(P<0.05);观察组初产妇在进入手术室和气管拔管时的心率与收缩压均较同期对照组平稳,差异均有统计学意义(P<0.05);观察组初产妇在进入手术室、手术开始1h及术后3 h时的促甲状腺激素、皮质醇以及血糖水平明显优于同期对照组(P<0.05);观察组术后6、12 h和24 h的视觉模拟评分低于同期对照组(P<0.05)。结论:耳穴贴压联合个性化音乐疗法较单纯个性化音乐疗法更能减少初产妇围手术期应激反应,促使其心理、生理及情绪改善。

Objective To explore the effect of auricula-point pressure combined with personalized music therapy on perioperative stress response in primipara. Methods A total of 1000 primiparas who were elective for cesarean section were randomly divided into an observation group and a control group, 500 cases in each one. 1 h before surgery and 3 h, 6 h, 12 h and 24 h after surgery, individualized music relaxation intervention was given for 1 h in the two groups. On the basis of the treatment, auricular-point pressure was added at Pizhixia(AT4), Shenmen(TF4), Xin(CO15), Zigong(uterus), Luanchao(ovary), Neishengzhiqi(TF2) in the observation group. Each point was pressed for 1 min each time, repeated once every 15 min, the force is from light to heavy, and it is better to have a feeling of distension, sourness and radiation in the auricle. The scores of anxiety self-rating scale, visual analog scale(VAS), heart rate, systolic blood pressure, thyroid stimulating hormone,cortisol and blood glucose levels were observed in the two groups. Results A total of 973 primiparas completed the clinical study in the end, including 488 patients in the observation group and 485 patients in the control group. Compared to enrollment, the scores of anxiety self-rating scale before entering the operating room in the two groups were significantly improved(P<0.05), and the observation group was superior to the control group(P<0.05). Entering the operating room and tracheal extubation, the heart rate and systolic blood pressure of the primiparas in the observation group were more stable than those in the control group, and the differences were statistically significant(P<0.05). Entering the operating room, 1 h into the surgery and 3 h after surgery, the thyroid stimulating hormone, cortisol and blood glucose levels of the primiparas in the observation group were significantly better than those in the control group(P<0.05). The VAS scores in the observation group at 6 h, 12 h and 24 h after surgery were lower than those in the control group(P<0.05). Conclusion Auricular-point pressure combined with personalized music therapy can reduce the perioperative stress response in primipara and promote the improvement of psychological, physiological and emotional.