穴位按摩联合舒适干预对功能性鼻内镜术后患者舒适度及心理应激的影响

Combined acupoint massage with comfort intervention on comfortableness and psychological stress in patients underwent functional endoscopic sinus surgery

目的 探讨功能性鼻内镜术后应用穴位按摩联合舒适干预对患者舒适度及心理应激的影响。方法 选择2019年6月至2021年5月收治的接受功能性鼻内镜术治疗的患者118例,根据干预方案不同分为对照组和观察组,每组59例,对照组给予常规护理,观察组在常规护理基础上给予穴位按摩联合舒适干预,对2组患者术后舒适度和疼痛情况进行评估,并对比2组干预前后心理状况评分、生理应激指标(心率、平均动脉压、皮质醇和促肾上腺皮质激素)。结果 干预前2组指标均无显著差异(P>0.05),观察组术后第3天舒适度高于对照组(t=2.814,P=0.010,P<0.05),且术后3 d的疼痛程度轻于对照组(t=2.996,P=0.003,P<0.05),干预后观察组PSTR评分、HAMD评分、HAMA评分、心率、平均动脉压、皮质醇和促肾上腺皮质激素均低于对照组(t=2.879、3.100、3.175、3.021、2.292、3.957、2.253,P=0.005、0.002、0.002、0.003、0.004、0.000、0.026,P<0.05)。结论 穴位按摩联合舒适干预对功能性鼻内镜术后患者的干预效果良好,可提升患者术后舒适度,减轻患者术后疼痛,改善其不良情绪,减轻其生理应激反应,促进其术后鼻功能恢复,更利于其术后康复。

Objective To study the effect of acupoint massage combined with comfort intervention on comfortableness and psychological stress in patients underwent functional endoscopic sinus surgery(FESS).Methods From June 2019 to May 2021,totally 118 FESS patients treated in our hospital were enrolled,the patients were randomly assigned in 1∶1 ratio to receive routine nursing intervention(control group) or acupoint massage + comfortable intervention+ routine nursing intervention(the observation group).Postoperative comfortableness and pain scorce were evaluated,and psychological status scores and physiological stress indicators including heart rate(HT),mean arterial pressure(MAT),cortisol and adrenocorticotropic hormone(ACTH) were compared before and after intervention.Results There was no significant difference in observation indexes in groups before intervention(P>0.05).The 3-day comfortableness(t=2.814,P=0.010,P<0.05,respectively) and pain degree(t=2.996,P=0.003,P<0.05,respectively) in the observation group were superior to the control group.The 3-day pericapsular soft tissue and realignment(PSTR) score,the Hamilton Depression Rating Scale(HAMD) and the Hamilton Anxiety Scale(HAMA)score,HR,MAP,cortisol and ACTH in the observation group were lower than those in the control group(t=2.879,3.100,3.175,3.021,2.292,3.957,2.253;P=0.005,0.002,0.002,0.003,0.004,0.000,0.026;P<0.05;respectively).Conclusion For FESS patients,the two combinations has a good intervention effect.It can improve postoperative comfort,postoperative pain and negative emotions,and then reduce physiological stress response,promote function recovery,and more conducive to postoperative rehabilitation.