观察心理与音乐干预对妇科手术患者术前心理应激反应的影响  

Effects of Psychological or musical intervention on preoperative psychological stress response of the gynecological patients

作　　者：任建军[1] 田新民[1] 于希香[1] 夏建光[1] 马玉武[1] 赵煜毅[1] 

机构地区：[1]山东省德州市人民医院麻醉科,253014

出　　处：《临床麻醉学杂志》2010年第11期983-985,共3页Journal of Clinical Anesthesiology

摘　　要：目的通过观察接受不同干预方法的患者,寻找有效降低术前心理应激反应的方法。方法选择ASAⅠ或Ⅱ级、有相同音乐背景的妇科手术患者80例,随机分为心理干预组(P组)、音乐干预组(M组)和音乐与心理干预组(MP组)、对照组(C组),每组20例。对患者于术前1d进行术前访视,了解音乐背景、讲明研究目的及方法,评定患者焦虑水平,抽取血标本等。分别在入院后(T0)、入手术室动、静脉穿刺后5min(T1)、研究结束时(T2)抽取血样,用放射免疫测定法检测血浆皮质醇(Cor)浓度、高效液相色谱仪检测去甲肾上腺素(NE)和肾上腺素(E)浓度。记录各组T1、T2时脑电双频指数(BIS)、MAP、HR。结果与C组比较,T1、T2时P、MP组Cor、E、NE均降低(P<0.05);与T1时比较,T2时P、M和MP组MAP降低,HR减慢(P<0.05);与MP组比较,T1、T2时M组、T2时P组Cor、E、NE明显升高(P<0.05)。与C组比较,T2时P、M和MP组MAP降低,HR减慢(P<0.05);与MP组比较,T2时P、M组MAP升高、HR增快(P<0.05)。T2时M、MP组BIS明显低于C、P组(P<0.05)。结论心理干预复合个体化音乐疗法是降低患者术前心理应激反应较为有效的方法。Objective To investigate the effects of different intervention on preoperative stress response of the gynecological patients. Methods Eighty patients,ASA Ⅰ or Ⅱ,aged 27-33 year,measured with same anxiety score by the State-Trait Anxiety Inventory （STAI）.All the patients were divided into control group（group C）,psychological intervention group（group P）,music group（group M） and music combined with psychological intervention group （group MP）randomly 20 cases in each group. All the work should be completed before the day of operation in preoperative interview with individuals,including acquirement the message of patient＇s music hobby,explaining the purpose and methods of the trial,evaluating the patient＇s anxious level.Getting Blood samples at hospitalization （T0）,5 minutes later of the completion venepuncture and arteriopuncture in operating room（T1）,the time point at the end of trail（T2）.The concentration of cortisone in plasma was detected by radioimmunoassay,the concentration of norepinephrine and epinephrine were detected by high performance liquid chromatogram method. The values of mean arterial pressure （MAP）,heart rate （HR）and （BIS）at T1、T2 were recorded.Results Compared with group C,the value of Cor,E,NE at T1,T2 in groups M and MP were decreased（P0.05）,the variation of Cor has statistical significan.The value of Cor,E and NE at T2 in groups P and MP were decreased （P0.05）; Compared with groups P and M,the indexes in group MP at T2 were decreased（P0.05）.The value of MAP,HR at T2 in group MP were lower than that in groups C,M and P（P0.05）. The BIS value at T2 in group MP were decreased compared to that in groups C and P（P0.05）,but no difference than that in group M.Conclusion The measure which music combined with psychological intervention was more available to decrease the preoperative psychological stress response than that of music or psychological intervention was used simply.

关 键 词：音乐 心理干预 手术前护理 应激 

分 类 号：R473.6[医药卫生—护理学]