围术期不同阶段心理干预对全麻患者术后疼痛及生活质量的影响

Effects of psychological intervention in different stages of perioperative period on postoperative pain and quality of life in patients with general anesthesia

目的在肝胆外科全麻术后患者恢复过程中,实施不同阶段的心理干预,以期达到增加患者对疾病的应对能力,提高生活质量。方法选取2017年8月5日-2018年9月23日在某院行肝胆手术患者90例作为研究对象,所有入选者均于全麻下进行手术,根据患者护理方式的不同分为实验A组、实验B组、对照组,每组30例。对照组给以常规心理干预联合术后常规止痛,实验B组在对照组基础上给予有效心理干预,而实验A组在对照组基础上给予有效心理干预联合术后充分止痛。结果通过临床护理干预,结果显示:三组患者术后疼痛程度随着护理时间的延长,改善程度越显著,其中,A组的改善效果最为显著,实验B组次之,最后为对照组,差异有统计学意义,P<0.05;经临床护理干预,对照组、实验B组、实验A组面对疾病评分逐步增高(16.13±4.08,18.39±6.57,20.82±4.12)分,回避评分逐步减低(16.03±4.18,15.18±4.43,13.25±4.53)分,屈服评分逐步降低(12.13±3.16,10.93±3.72,9.64±3.85),三组中以实验A组改善情况最为显著(t=-5.996、t=-3.153、t=-2.002),其次为实验B组(t=4.564、t=2.725、t=2.035),最后为对照组(t=4.718、t=3.445、t=2.113),且差异有统计学意义,P<0.05;实验组患者的PF、VT、MH、HT、GH、SF、RP及RE评分均高于对照组,BP评分低于对照组,且实验A组的生活质量优于实验B组,差异有统计学意义,F=42.024、F=15.872、F=22.531、F=29.153、F=10.740、F=11.375、F=28.502、F=16.229、F=11.826、P<0.05。结论对肝胆外科全麻手术患者实施围术期不同阶段心理干预能有效增强其对疾病的应对能力,降低术后疼痛感,提高生活质量。

Objective To investigate the effect of perioperative psychological intervention at different stages in the postoperative recovery process of patients undergoing general anesthesia in hepatobiliary surgery.Methods 90 patients who undergoing hepatobiliary surgery from August 52017 to September 232018.All the selected patients were operated under general anesthesia,According to the different nursing methods of patients,they were divided into experimental group A,experimental group B and control group,30 cases in each group.The control group was given conventional psychological intervention,the experimental group B was given effective psychological intervention on the basis of the control group,and the experimental group A was given effective psychological intervention combined with postoperative analgesia on the basis of the control group.Comparison of postoperative pain,coping style,and postoperative quality of life between the three groups.Results Through clinical nursing intervention,the postoperative pain of patients in the three groups improved more significantly with the extension of nursing time,of which the improvement effect was the most significant in experiment group A,followed by experiment group B,and finally the control group,The difference was statistically significant(P<0.05).After clinical nursing intervention,the scores of disease in the control group,experimental group B and experimental group A gradually increased(16.13±4.08,18.39±6.57,20.82±4.12),and the avoidance scores decreased gradually(16.03±4.18,15.18±4.43,13.25±4.53).The yield score gradually decreased(12.13±3.16,10.93±3.72,9.64±3.85).Among the three groups,the improvement of experimental group A was the most significant(t=-5.996,t=-3.153,t=-2.002),followed by experimental group B(t=4.564,t=2.725,t=2.035),and finally the control group(t=4.718,t=3.445,t=2.113),and the difference was statistically significant(P<0.05).The scores of PF,VT,MH,HT,GH,SF,RP and RE in the experimental group were higher than those in the control group,while the BP score was lower than that in the control group.The quality of life in experimental group A was better than that in experimental group B,and the difference was statistically significant.F=42.024,F=15.872,F=22.531,F=29.153,F=10.740,F=11.375,F=28.502,F=16.229,F=11.826,P<0.05.Conclusion Psychological intervention in patients undergoing general anesthesia during hepatobiliary surgery can effectively enhance their ability to cope with disease,reduce postoperative pain,and improve quality of life.