手术室环境对人工股骨头置换术患者等待期应激反应的影响

Effect of the operating room environment on the stress response during the waiting period in patients with artificial femoral head replacement

目的探讨手术室环境对人工股骨头置换术患者等待期应激反应的影响。方法回顾性选取2021年1月1日—2023年7月31日入院的84例患者,患者均需要接受人工股骨头置换术治疗。根据患者接受治疗时手术室的环境将患者分为两组,对照组42例患者,其接受手术治疗时手术室环境未改造升级;观察组42例患者,其接受手术治疗时手术室环境已改造升级。对比两组应激反应(肾上腺素、皮质醇水平)、情绪状态[汉密尔顿抑郁量表(HAMD)评分、汉密尔顿焦虑量表(HAMA)评分]、血压(收缩压、舒张压、心率)、生活质量评分、患者对手术室环境的满意度。结果T_(1)时刻,两组肾上腺素、皮质醇水平均升高,但对照组升高幅度[(43.48±4.59)pg/L、(268.48±13.55)ng/L]大于观察组[(38.15±5.28)pg/L、(240.15±12.48)ng/L],对比差异有统计学意义(t=4.937、9.967,P<0.05)。T_(1)时刻,两组HAMD、HAMA评分均升高,对照组水平[(22.84±3.26)(24.03±3.47)分]大于观察组[(19.75±3.73)(20.76±3.36)分],对比差异有统计学意义(t=4.042、4.387,P<0.05)。T_(1)时刻,两组收缩压、舒张压、心率水平均显著升高,但对照组升高幅度[(129.34±7.25)mmHg、(94.25±6.62)mmHg、(88.58±3.27)次/分]大于观察组[(117.62±8.13)mmHg、(85.63±5.38)mmHg、(82.16±3.66)次/分],对比有统计学意义(t=6.973、6.549,8.477,P<0.05)。术后5 d,两组各维度评分均显著升高,观察组各维度评分高于对照组(P<0.05)。观察组患者对手术室环境的满意率高于对照组(97.62%vs 85.71%,χ^(2)=3.896,P=0.048)。结论手术室环境改造升级对人工股骨头置换术患者具有积极作用,可有效降低患者等待期应激反应,减轻患者等待期焦虑、抑郁情绪,降低患者等待期血压、心率上升幅度,有利于提升患者术后生活质量,提高患者对手术室环境的满意度。

Objective To investigate the effect of operating room environment on stress response during the waiting period in patients with artificial femoral head replacement.Methods Eighty-four patients admitted between January 1,2021 to July 31,2023 required artificial femoral head replacement.According to the operating room environment during treatment,the patients were divided into two groups.Forty-two patients in the control group received the surgical treatment in the original operating room environment and 42 patients received surgical treatment in upgraded environment.Comparing two groups of stress response(adrenaline,cortisol),emotional status[HAMD score,HAMA score],blood pressure(systolic blood pressure,diastolic blood pressure,heart rate),quality of life,patient satisfaction with the operating room environment of two groups were compared.Results At time T_(1),epinephrine and cortisol levels were significantly increased in the two groups,but the control group increased[(43.48±4.59)pg/L,(268.48±13.55)ng/L]greater than the observation group[(38.15±5.28)pg/L,(240.15±12.48)ng/L],which were statistically significant(t=4.937,9.967,P<0.05).At time T_(1),the HAMD and HAMA scores were significantly higher in both groups,but the increase[(22.84±3.26)and(24.03±3.47)]was greater than the observation group[(19.75±3.73)and(20.76±3.36)],which showed statistical significance(t=4.042,4.387,P<0.05).At time T_(1),SBP,DBP and heart rate increased significantly in both groups,but the control group increased[(129.34±7.25)mmHg,(94.25±6.62)mmHg,(88.58±3.27)][(117.62±8.13)mmHg,(85.63±5.38)mmHg,(82.16±3.66)/min]grater than the observation group(t=6.973,6.549,8.477,P<0.05).Five days after surgery,the scores of each dimension increased significantly in both groups,but the observation group increased more than the control group(P<0.05).The observation group patients showed a higher satisfaction rate of the operating room environment than the control group(97.62%vs 85.71%,χ^(2)=3.896,P=0.048).Conclusions The transformation and upgrading of the operating room environment has a positive effect on the patients with artificial femoral head replacement,which can effectively reduce the stress response of patients during the waiting period,reduce the anxiety and depression of patients during the waiting period,and reduce the rise in blood pressure and heart rate of patients during the waiting period,which is conducive to improving the quality of life of patients after surgery and improving the satisfaction of patients with the operating room environment.