心理干预对椎体后凸成形术(PKP)治疗胸腰椎压缩性骨折患者应激状态及疼痛程度的影响

Effect of psychological intervention on stress state and pain degree of thoracolumbar compression fracture patients underwent percutaneous kyphoplasty

目的:探讨心理干预对椎体后凸成形术(Percutaneous kyphoplasty,PKP)治疗胸腰椎压缩性骨折患者应激状态及疼痛程度的影响。方法:选取2016年10月至2017年10月我院收治的196例胸腰椎压缩性骨折患者,根据随机数字表法将其分为对照组与观察组,每组98例,对照组患者接受常规干预,观察组患者在对照组的基础上增加心理干预,均干预2个月,采用焦虑自评量表(SAS)和抑郁自评量表(SDS)对患者的焦虑和抑郁进行评价,心理弹性采取心理韧性量表评分评价,分析患者治疗前后的心理应激状态,NRS疼痛评分情况。结果:干预前,两组患者的焦虑及抑郁程度组间无显著差异;干预后,两组患者抑郁及焦虑程度均降低,且观察组的焦虑及抑郁评分均低于对照组(t=-21.070,-24.511;P<0.001);干预前,两组患者的心理弹性(坚韧及力量、乐观)比较,均无明显差异;干预后,两组患者的心理弹性评分均有所增加,且观察组患者的总分增加幅度大于对照组(t=18.834,P<0.001);两组入院时,疼痛指数无差异,在术后24h、72h比较均有明显差异,具有统计学意义(F=25.46,P<0.001);且随着时间的延长,患者的疼痛均会减轻。结论:对PKP治疗胸腰椎压缩性骨折患者应用心理干预模式可有效改善患者的应激状态,减缓患者疼痛感,有助于疾病康复,值得推广。

Objective:To investigate effect of psychological intervention on stress state and pain degree of thoracolumbar compression fracture patients underwent percutaneous kyphoplasty(PKP).Methods:A total of 196 cases with thoracolumbar compression fracture admitted to our hospital from October 2016 to October 2017 were selected and were divided into control group and observation group by random number table method,each with 98 cases.The control group received the routine intervention,based on this,the observation group received the psychological intervention,both tid for 2 mon.The self rating Anxiety Scale(SAS)and self rating Depression Scale(SDS)were used to evaluate the patient’s an xiety and depression,psychological resilience by mental toughness scale evaluation.The psychological stress of patients before and after treatment,NRS score of pain were investigated.Results:The anxiety and depression scores of the two groups had no significant difference before intervention,which were decreased after intervention,and those in the observation group were lower than that in the control group(t=-21.070,-24.511;P<0.001).The psychological resilience including toughness,strength,optimism of the two groups showed no significant difference before intervention,which were significantly improved after intervention in both groups,and the increasing level was more obvious in the observation group than that in the control group(t=18.834,P<0.001).The pain degree of the two groups had no difference at the time of admission,which showed significant difference at the postoperative 24 h and 72 h(F=25.46,P<0.001),and were decreased with the prolonging of time.Conclusion:The implementation of the psychological intervention can effectively ameliorate the psychological status,alleviate the pain degree,thus promote the recovery for patients with thoracolumbar compression fracture.