术前心理疏导对全身麻醉患者苏醒期躁动的影响  

Effects of preoperative psychological intervention on restlessness in recovery period of patients with general anesthesia

作　　者：祝义军[1] 史东平[1] 封卫征[1] 

机构地区：[1]上海第二医科大学附属仁济医院嘉定分院麻醉科,上海嘉定201800

出　　处：《现代医药卫生》2006年第2期169-170,共2页Journal of Modern Medicine & Health

摘　　要：目的:观察术前心理疏导对全身麻醉患者苏醒期躁动发生率的影响。方法:80例成年全身麻醉下行择期腹部手术患者,无精神病、麻醉和手术史,随机分为心理疏导组(P组,n=40)和对照组(C组,n=40)。P组采取以下方法:利用术前访视掌握患者心理情况,施行个体化心理疏导,向患者提供全身麻醉的客观和主观感受信息,暗示麻醉的可靠性及安全性,帮助患者建立正确的心理防御机制;C组仅做常规访视。记录两组患者诱导前、术毕、拔管时,拔管后5、l0分钟各时段心率(HR)、血压(MAP)、脉搏血氧饱和度(SpO2);苏醒期躁动评分,Ramsay镇静评分,躁动发生率及程度。结果:两组麻醉效果、术后清醒时间、拔管时间和SpO2均无差异。麻醉苏醒期患者的HR、MAP升高幅度P组比C组低(P<0.05)。躁动发生率:P组22%(9/40);C组55%(22/40);P组苏醒期躁动评分为(0.85±0.41)分,Ramsay镇静评分为(2.53±0.48)分,C组分别为(1.48±0.46)分,(1.68±0.39)分,两组相比有明显差异(P<0.01)。结论:手术前施行心理疏导有助于降低全身麻醉患者苏醒期躁动的发生率。Objective：To observe the effects of preoperative psychological intervention on restlessness in recovery period of patients with general anesthesia.Methods：Eighty aduh patients （ ASA Ⅰ～Ⅱ ） scheduled for abdominal surgery under general anesthesia and no histories of psychosis, operation and anesthesia were randomly divided into psychologic intervention group （group P） and control group （group C）,with forty cases in each group.Patients just received routine visiting in the group C, while patients in the group P on the basis of routine visiting received some information about general anesthesia and alleviated their anxieties of anesthesia on the day before anesthesia.Some indices were observed such as the changes of HR, MAP and SpO2 at 5 intervals including pre-induction,skin closed,immediately after tracheal extubation, 5 min and 10 min after tracheal extubation. Remesay scores and Restlessness scores,the incidence and degree of restlessness were observed during recovery period of general anesthesia.Results：There were no differences in the wakening time,extubation time and SpO2 between two groups.In comparison with group C,thc circulation was steady in group P,with lower Restlessness score and higher Remesay score during recovery period.The incidence rate of restlessness in group P was 22%（9/40）.However, 55% （22/40） in group C. There was statistical significant difference between two groups （P〈0.01）. Conclusion：The preoperative psychologic intervention is available to decrease incidence of restlessness in recovery period of patients with general anesthesia.

关 键 词：心理疏导 全身麻醉 苏醒期 躁动 

分 类 号：R614[医药卫生—麻醉学]