全程心理疏导预防全麻术后导尿管刺激躁动的临床观察  

Clinical Observation of the Full Psychological Counseling to Prevent Catheter Stimulation After General Anesthesia

作　　者：王妍[1] 李仁奇[1] 祁闻[1] 杨敏[1] 金利[1] 

机构地区：[1]南京军区南京总医院麻醉科,江苏南京210002

出　　处：《现代生物医学进展》2012年第3期539-540,536,共3页Progress in Modern Biomedicine

摘　　要：目的:评价全程心理疏导预防全身麻醉术后导尿管刺激躁动的临床效果。方法:全麻下实施胆囊切除手术的80例男性患者为观察对象,随机均分为全程心理疏导组(Ⅰ组)和对照组(Ⅱ组),每组40例。Ⅰ组:术前、麻醉诱导前、苏醒后均对患者施行个体化心理疏导,根据患者具体情况进行沟通,解除其焦虑与恐惧心理。Ⅱ组:常规访视,不进行全程心理疏导。飞利浦多功能监测仪连续监测ECG、HR、SpO2及每3分钟监测一次BP,记录入室后MAP、HR的基础值(T0)、术毕(T1)、拔管后3 min(T2)、10 min(T3)、20min(T4)的血流动力学变化,观察记录拔管后患者因尿管刺激引发躁动评分。结果:Ⅰ组患者苏醒期对尿管刺激反应程度明显低于Ⅱ组,患者在苏醒期血压、心率也较稳定。结论:全程心理疏导可以预防、减轻全麻术后因导尿管刺激而引发的躁动。Objective： Evaluation of psychological counseling throughout the operation to prevent stimulation of the catheter after general anesthesia.Methods：To select 80 male patients of Cholecystectomy under general anesthesia surgery,and were randomly divided into full psychological counseling group（Ⅰgroup） and control group（Ⅱ group）.There are 40 cases in every group.In Ⅰ group： preoperative,before induction of anesthesia,the patient regained consciousness after implementation of all individual psychological counseling according to the specific situation of patients,and lift the anxiety and fear.In ⅡGroup： General visit and not to the whole psychological counseling.Continuous monitoring of ECG,HR,SpO2,and BP monitoring every 3 minutes.To record burglary MAP,HR at baseline（T0）,end of operation（T1）,after extubation 3 min（T2）,10 min（T3）,20min（T4） the hemodynamic changes.To observe scores of agitation caused by catheter stimulation after extubation.Results： In group Ⅰthe degree of stimulation was significantly lower than in group Ⅱ.In the recovery blood pressure,heart rate Were more stable in group Ⅱ.Conclusion： Full psychological counseling can prevent and reduce stimulation of catheter-induced agitation after general anesthesia.

关 键 词：心理疏导 全身麻醉 导尿管 术后躁动 血流动力学 

分 类 号：R614[医药卫生—麻醉学] R47[医药卫生—外科学]