无痛理念下认知行为干预对LC全麻患者舒适度、苏醒质量和预后的影响

Effect of Cognitive Behavioral Intervention under Painless Concept on Comfort,Quality of Recovery and Prognosis of LC General Anesthesia Patients

目的探讨无痛理念下认知行为干预对腹腔镜胆囊切除术(Laparoscopic Cholecystectomy,LC)全麻患者舒适度、苏醒质量和预后的影响。方法方便选取2021年1月—2022年12月福建省泉州市中国人民解放军联勤保障部队第910医院麻醉科收治的152例全麻腹腔镜胆囊切除术患者为研究对象,按电脑随机数表法分为观察组和对照组,各76例。对照组实施围术期常规护理,观察组在常规基础上结合无痛理念下认知行为干预,比较两组护理前后舒适度变化、苏醒治疗情况、疼痛及预后恢复。结果观察组苏醒质量评分高于对照组,苏醒时间短于对照组,差异有统计学意义(P均<0.05);护理结束时,观察组舒适状况量表评分高于对照组,差异有统计学意义(P<0.05);术后7 d,两组疼痛强度简易量表评分较术后1 d降低且观察组低于对照组,差异有统计学意义(P均<0.05);护理结束时,两组焦虑自评量表、抑郁自评量表评分较护理前降低且观察组评分低于对照组,差异有统计学意义(P均<0.05);观察组术后麻醉相关并发症发生率为5.26%,与对照组的10.53%比较,差异无统计学意义(χ^(2)=1.448,P>0.05)。结论在LC全麻围术期应用无痛理念下认知行为干预可改善患者苏醒质量,缓解负性情绪,减轻术后痛感,提高身心舒适度。

Objective To explore the effects of painless cognitive behavioral intervention on comfort,quality of recovery and prognosis of patients undergoing laparoscopic cholecystectomy(LC)under general anesthesia.Methods A total of 152 patients with laparoscopic cholecystectomy under general anesthesia admitted to the 910th Hospital of the Chinese People's Liberation Army Joint Logistics Support Force in Quanzhou,Fujian Province from January 2021 to December 2022 were conveniently selected as the study objects,and were divided into observation group and control group according to computerized random number table method,with 76 cases in each group.The control group received perioperative routine nursing,and the observation group received cognitive behavioral intervention combined with painless concept on the basis of routine.The changes of comfort,recovery treatment,pain and prognosis were compared between the two groups before and after care.Results The recovery quality score of the observation group was higher than that of the control group,and the recovery time was shorter than that of the control group,and the difference was statistically significant(both P<0.05);at the end of nursing,the General Comfort Questionnaire score of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05);the Numerical Rating Scale score of the two groups was lower on day 7 after surgery than on the first day after surgery,and the observation group was lower than the control group,and the differences were statistically significant(all P<0.05);after nursing,the scores of Self-rating Anxiety Scale and Self-rating Depression Scale in the two groups were lower than those before nursing,and the scores in the observation group were lower than those in the control group,and the differences were statistically significant(all P<0.05);there was no statistically significant difference in incidence of postoperative anesthesia related complications between 5.26%in the observation group and 10.53%in the control group(χ^(2)=1.448,P>0.05).Conclusion Cognitive behavioral intervention under painless concept during perioperative period of LC general anesthesia can improve patients'recovery quality,relieve negative emotions,reduce postoperative pain and improve physical and mental comfort.