优化手术室护理配合心理疏导对胸腰椎骨折行经皮椎体成形术患者应激反应与疼痛程度的影响

Effect of Optimizing Operating Room Nursing Combined with Psychological Counseling on Stress Response and Pain Level in Patients Undergoing Percutaneous Vertebroplasty for Thoracolumbar Fractures

目的探讨优化手术室护理配合心理疏导对胸腰椎骨折行经皮椎体成形术患者应激反应、疼痛程度的影响。方法选取2021年1月至2022年12月于高安市中医院行经皮椎体成形术的72例胸腰椎骨折患者作为研究对象,按随机数字表法分为对照组与观察组,各36例。对照组予以常规护理,观察组实施优化手术室护理配合心理疏导,均护理至患者出院。比较两组应激反应、疼痛程度、不良情绪、舒适度、并发症。结果两组术前应激反应指标比较差异无统计学意义(P>0.05);观察组术后24 h舒张压、收缩压、心率均较对照组低(P<0.05)。观察组术后3 h、6 h、12 h的视觉模拟评分法(VAS)评分均较对照组低(P<0.05)。两组护理前抑郁自评量表(SDS)、焦虑自评量表(SAS)评分比较差异无统计学意义(P>0.05);观察组护理后SDS、SAS评分均较对照组低(P<0.05)。两组护理前生理维度、心理维度、社会文化维度、环境维度评分比较差异无统计学意义(P>0.05);观察组护理后生理维度、心理维度、社会文化维度、环境维度评分高于对照组(P<0.05)。观察组并发症发生率低于对照组(P<0.05)。结论优化手术室护理配合心理疏导能够减轻胸腰椎骨折行经皮椎体成形术患者应激反应、不良情绪,缓解疼痛,降低并发症发生率,提高舒适度。

Objective To explore the effect of optimizing operating room nursing combined with psychological counseling on stress response and pain level in patients undergoing percutaneous vertebroplasty for thoracolumbar fractures.Methods A total of 72 patients with thoracolumbar fracture who underwent percutaneous vertebroplasty in Gao'an Hospital of Traditional Chinese Medicine from January 2021 to December 2022 were selected as the study objects,and were divided into control group and observation group according to random number table method,with 36 cases in each group.The control group was given routine nursing,and the observation group was given optimal operating room nursing combined with psychological counseling until the patients were discharged.The stress response,pain degree,bad mood,comfort level and complications were compared between the two groups.Results There was no significant difference in preoperative stress response indexes between the two groups(P>0.05).The diastolic blood pressure,systolic blood pressure and heart rate of observation group were lower than those of control group 24 h after operation(P<0.05).Visual analogue scale(VAS)scores of the observation group at 3 h,6 h and 12 h after operation were lower than those of the control group(P<0.05).There was no significant difference in self-rating depression Scale(SDS)and self-rating Anxiety Scale(SAS)scores between the two groups before nursing(P>0.05).SDS and SAS scores of the observation group were lower than those of the control group(P<0.05).There was no significant difference in the scores of physiological dimension,psychological dimension,sociocultural dimension and environmental dimension between the two groups before nursing(P>0.05).The scores of physiological dimension,psychological dimension,sociocultural dimension and environmental dimension after nursing in the observation group were higher than those in the control group(P<0.05).The complication rate of observation group was lower than that of control group(P<0.05).Conclusion Optimization of operating room nursing combined with psychological counseling can alleviate stress reaction,bad mood,relieve pain,reduce complication rate and improve comfort in patients undergoing percutaneous vertebroplasty for thoracolumbar fracture.