心理调适能力干预对胆囊切除术患者围手术期情绪状态及应激反应的影响

Effects of Psychological Adjustment Ability Intervention on Perioperative on Emotional State and Stress Response in Patients Undergoing Cholecystectomy

目的探讨心理调适能力干预对腹腔镜胆囊切除术(LC)患者围手术期情绪状态及应激反应的影响。方法选取黄河中心医院2019年1月至2022年12月收治的120例拟行LC手术患者,按病区分组,各60例。对照组接受常规护理,观察组在此基础上接受心理调适能力干预,干预至出院。比较两组康复进度、术后并发症发生率及不同时间点情绪状态[汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)]、生理应激反应[C反应蛋白(CRP)、心率(HR)、空腹血糖(FPG)、外周血白细胞(WBC)计数]、疼痛程度[视觉模拟法(VAS)]。结果观察组术后排气、下床活动、进食及住院时间均短于对照组(P<0.05);术前1 d、出院前1 d观察组HAMA、HAMD评分较对照组降低(P<0.05);术后1 d观察组CRP、FPG、WBC与HR均低于对照组(P<0.05);术后1、3 d,观察组VAS评分低于对照组(P<0.05);观察组术后并发症与对照组比较,差异无统计学意义(P>0.05)。结论心理调适能力干预能减轻LC患者围手术期生理应激反应,改善消极情绪状态,缓解术后疼痛感,有利于促进患者康复。

Objective To investigate the effects of psychological adjustment ability intervention on perioperative emotional state and stress response in patients undergoing laparoscopic cholecystectomy(LC).Methods A total of 120 patients who were expected to undergo LC surgery in Yellow River Central Hospital from January 2019 to December 2022 were selected and divided,with 60 patients in each ward.The control group was given routine nursing,and the observation group was given psychological adjustment ability intervention on this basis until discharge.The recovery progress,postoperative complication rate,emotional state[Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD)],physiological stress response[C-reactive protein(CRP),heart rate(HR),fasting plasma glucose(FPG),peripheral blood white blood cell(WBC)count]and pain degree[visual analogue scale(VAS)]were compared between the two groups.Results Postoperative exhaust,ambulation,feeding and hospitalization time in observation group were shorter than those in control group(P<0.05).HAMA and HAMD scores in observation group were lower than those in control group 1 day before surgery and 1 day before discharge(P<0.05).The CRP,FPG,WBC and HR in observation group were lower than those in control group one day after surgery(P<0.05).The VAS score of observation group was lower than that of control group one day and three days after surgery(P<0.05).There was no significant difference in postoperative complications between observation group and control group(P>0.05).Conclusion Psychological adjustment ability intervention can alleviate perioperative physiological stress response,improve negative emotional state,relieve postoperative pain and promote recovery of patients with LC.