高龄髋部骨折患者围手术期心理治疗  

Psychotherapy in peri-operation of the aged hip fracture

作　　者：路微波[1] 孙宏伟[1] 戴垚 刘忠明[1] 王丽华[1] 胡永善[2] 吴毅[2] 姜鹭春[2] 

机构地区：[1]上海市杨浦区老年医院康复科 [2]复旦大学附属华山医院康复医学中心,200040

出　　处：《淮海医药》2008年第4期298-300,共3页Journal of Huaihai Medicine

摘　　要：目的评价心理治疗在高龄髋部骨折患者围手术期的临床应用及对患者术后日常生活自理能力恢复的影响。方法采用前瞻性对比研究,80例80岁以上髋部骨折患者,随机分为心理治疗组和对照组(每组各40例)。2组手术前准备、手术和术后康复治疗相同。心理治疗组针对患者入院时的抑郁、术前的焦虑、术中的恐惧及术后的幼稚等心理活动特点,增加由心理治疗师组成的治疗组给予心理关怀、心理疏导、心理按摩和心理暗示等心理治疗项目。结果心理治疗组患者在院期间汉密尔顿焦虑量表评分显示:抑郁、焦虑心境的缓解程度较对照组明显,差异有显著性(P<0.05);术后4个月日常生活自理能力改良Barthel指数评分也明显高于对照组,差异有显著性(P<0.05)。结论围手术期心理治疗可以明显缓解高龄髋部骨折患者的抑郁和焦虑心境,对术后日常生活自理能力恢复有明显的促进作用。Objective To assess the effect of peri-operative psychotherapy on postoperative activities of daily living （ADL） in the aged hip fracture. Methods It was a randomized controlled trial. Eighty patients with hip fracture,aged above 80 years old,were randomized to receive psychotherapy or not in addition to the same preoperative preparative operation and postoperative rehabilitation. Results The anxiety assessment of Hanmilton scale showed that the anxiety in the psychotherapy group was significantly improved than in the control group （ P 〈 0. 05 ）. Significantly greater gains were seen in Barthel Index of ADL for the psychotherapy group 4 months after operation （ P 〈 0.05 ）. Conclusion Data suggest that peri-operative psychotherapy benefits postoperative ADL in the aged hip fracture.

关 键 词：髋骨折 手术期间 心理治疗 老年人 80以上 

分 类 号：R681.6[医药卫生—骨科学]