心理护理对腹腔镜胆囊切除术患者应激反应的影响  

Effects of psychological nursing on surgical stress during laparoscopic cholecystectomy

作　　者：陈小凤[1] 郑芳[1] 陈殷琴[1] 曹何琼[1] 

机构地区：[1]广东医学院附属医院肝胆外科,广东湛江524001

出　　处：《国际护理学杂志》2009年第4期539-541,共3页international journal of nursing

摘　　要：目的探讨心理护理对腹腔镜胆囊切除术患者应激反应的影响。方法腹腔镜胆囊切除术患者120例，随机分为对照组和心理护理组各60例。对照组患者术前、术中、术后进行常规护理；心理护理组术前、术中、术后进行常规护理的同时进行心理护理。观察两组患者血糖（Glu）、皮质醇（C01）、肾上腺素（E）、去甲肾上腺素（NE）、血压、心率、术后疼痛评分、恶心呕吐及恢复情况。结果对照组手术前即刻及术中收缩压较入院时明显升高，心率也明显加快；而心理护理组无明显变化，常规剂量镇痛剂能安静入睡患者的比例心理护理组高于对照组；对照组在人手术室后、手术开始后30rain血浆Glu、Col、E和NE浓度均高于心理干预组；术后疼痛评分心理护理组小于对照组；心理护理组恶心呕吐发生率低于对照组。结论心理护理能显著减轻腹腔镜胆囊切除术患者应激反应，减少并发症及加快术后康复。Objective To study the effects of psychological nursing on surgical stress during laparoseopic cholecystectomy. Methods 120 eases of laparoscopic cholecystectomy patients were randomly divided into cantrol group and psychological nursing group, each group was 60 cases. Control group was accepted normal nursing and psychological nursing group was accepted normal nursing and psychological nursing. The blood sugar, blood cortisol, epinephrine and norepinephrine were detected, and the visual analgesia score, postoperative nausea and vomiting, postoperative recovery were also recorded and compared between the two groups. Results The systolic blood pressure and heart rate of control group at the time just befor operation, and the during the operation were significantly higher than basic value, meanwhile the systolic blood pressure and heart rate were stable in psycholog- ical nursing group. The blood sugar, eortisol, epinephrine and norepinephrine in control group were higher than those in psychological nursing group at every investigation time poit, visual analgesia score was lower in psychological nursing group than that in control group; postoperative nausea and vomiting in psychological nursing group were lower than those in the control group. Conclusions Psychological nursing can reduce the surgical stress and facilitate the postoperative recovery in laparoscopic cholecystectomy patients.

关 键 词：腹腔镜胆囊切除 心理护理 应激反应 

分 类 号：R473.6[医药卫生—护理学] R471[医药卫生—临床医学]