术前积极心理暗示结合术中复合保温措施对择期腹腔镜下胆囊切除术患者术前焦虑及术中应激反应的影响

Effects of preoperative positive psychological suggestion combined with intraoperative composite thermal insulation measures on preoperative anxiety and intraoperative stress response in patients undergoing elective laparoscopic cholecystectomy

目的分析术前积极心理暗示结合术中复合保温措施对择期腹腔镜下胆囊切除术患者术前焦虑及术中应激反应的影响。方法选择2019年4月至2022年5月我院收治的100例择期行腹腔镜下胆囊切除术治疗的结石性胆囊炎患者为研究对象,以随机数字表法将其分为对照组(n=50)与观察组(n=50)。对照组接受常规护理,观察组在对照组基础上给予术前积极心理暗示结合术中复合保温措施。比较两组的干预效果。结果干预后,观察组的抑郁自评量表(SDS)、焦虑自评量表(SAS)评分低于对照组(P<0.05)。术中30 min、术毕时,观察组的促肾上腺皮质激素(ACTH)、促肾上腺皮质激素释放激素(CRH)及皮质醇(Cor)水平均低于对照组(P<0.05)。术中30 min、出手术室时,观察组的体温高于对照组(P<0.05)。观察组的不良反应总发生率低于对照组(P<0.05)。结论术前积极心理暗示结合术中复合保温措施不仅可改善择期腹腔镜下胆囊切除术患者的术前焦虑,维持体温状态,还能缓解术中应激反应,降低不良反应发生率,值得推广。

Objective To analyze the effects of preoperative positive psychological suggestion combined with intraoperative composite thermal insulation measures on preoperative anxiety and intraoperative stress response in patients undergoing elective laparoscopic cholecystectomy.Methods A total of 100 patients with calculous cholecystitis who underwent elective laparoscopic cholecystectomy admitted in our hospital from April 2019 to May 2022 were selected as the research objects,and the patients were divided into control group(n=50)and observation group(n=50)by random number table method.The control group received routine nursing,and the observation group was given preoperative positive psychological suggestion combined with intraoperative composite thermal insulation measures on the basis of the control group.The intervention effects of the two groups were compared.Results After intervention,the scores of Self-Rating Depression Scale(SDS)and Self-Rating Anxiety Scale(SAS)in the observation group were lower than those in the control group(P<0.05).At 30 min of operation and at the end of operation,the levels of adrenocorticotropic hormone(ACTH),corticotropin releasing hormone(CRH)and cortisol(Cor)in the observation group were lower than those in the control group(P<0.05).At 30 min of operation and when leaving the operating room,the body temperature of the observation group was higher than that of the control group(P<0.05).The total incidence of adverse reactions in the observation group was lower than that in the control group(P<0.05).Conclusion Preoperative positive psychological suggestion combined with intraoperative composite thermal insulation measures can not only improve preoperative anxiety and maintain body temperature in patients undergoing elective laparoscopic cholecystectomy,but also alleviate intraoperative stress response and reduce the incidence of adverse reactions,which is worthy of promotion.