综合管理干预对胃肿瘤患者无痛胃镜检查心理和生理应激反应的影响

Effect of comprehensive management intervention on the psychological and physiological stress reactivity of painless gastroscopy in patients with gastric tumor

目的探讨综合管理干预对胃肿瘤患者进行无痛胃镜检查时心理和生理应激反应的影响。方法采用随机数字表法将216例胃肿瘤患者分为试验组和对照组,各108例。对照组患者给予常规护理干预,试验组患者在常规护理的基础上给予综合管理干预。比较两组患者的心率(HR)、收缩压(SBP)、舒张压(DBP)、去甲肾上腺素(NE)水平、胃镜接受程度、疼痛程度以及抑郁和焦虑情况。结果护理后,试验组的HR、SBP、NE水平均明显低于对照组(P<0.01),但两组患者的DBP水平比较,差异无统计学意义(P>0.05)。试验组对胃镜的接受能力明显优于对照组,对胃镜的接受度明显高于对照组(P<0.01)。护理后,试验组的恶心呕吐次数少于对照组(P<0.05)。护理后,试验组的抑郁自评量表(SDS)、焦虑自评量表(SAS)评分、心理应激率以及苏醒即刻(T0)、苏醒后10 min(T1)、苏醒后60 min(T2)的视觉模拟评分法(VAS)评分均明显低于对照组(P<0.01)。结论综合管理干预护理手段可以有效缓解接受无痛胃镜检查的胃肿瘤患患者的生理应激和心理应激反应,值得临床推广与应用。

Objective To investigatethe effect of comprehensive management intervention on the psychological and physiological stress reactivity of patients with gastric tumor undergoing painless gastroscopy.Method A total of 216 gastric tumor patients were divided into an experimental group and a control group using random number table method with 108 cases in each.Patients in the control group were given conventional nursing intervention,and patients in the experimental group were given comprehensive management intervention on the basis of conventional nursing care.The heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP),norepinephrine(NE)level,gastroscopy acceptance,pain level,depression and anxiety of the two groups were compared between the two groups.Result After nursing,the HR,SBP and NE levels of the experimental group were significantly lower than those of the control group(P<0.01),but there was no statistically significant difference in the DBP levels between the two groups(P>0.05).The patients in the experimental group showed significant higher acceptance of gastroscope than those in the control group,and thus more patients in the experimental group received gastroscope(P<0.01).After nursing,the incidence of nausea and vomiting in the experimental group was less than that in the control group(P<0.05).After nursing,the scores of self-rating depression scale(SDS),self-rating anxiety scale(SAS),psychological stress rate,and visual analogue scale(VAS)at three different sessions[immediately after resuscitation(T0),10 min after resuscitation(T1),60 min after resuscitation(T2)]of the experimental group were significantly lower than those of the control group(P<0.01).Conclusion Comprehensive management intervention nursing methods can effectively alleviate the physiological and psychological stress reactivity of patients with gastric tumors undergoing painless gastroscopy,and are worthy of clinical promotion and application.