术前护理访视对骨科手术患者围术期应激反应的影响  

The impact of preoperative nursing visiting care on patients with orthopedic surgery perioperative stress response

作　　者：冯玲[1] 谭颖微[2] 

机构地区：[1]杭州钢铁集团公司职工医院手术室,浙江杭州310022 [2]第三军医大学新桥医院骨科,重庆400037

出　　处：《中国现代医生》2013年第34期119-121,125,共4页China Modern Doctor

基　　金：国家自然科学基金(30973334)

摘　　要：目的研究骨科手术患者术前心理应激状态及术前护理访视对其围手术期应激反应的影响。方法选择120例骨折患者随机分为观察组和对照组,观察组在术前1天由手术室护士进行护理访视,比较两组术前及手术过程血压、心率和血糖的变化情况。结果 120例骨科患者术前心理应激以焦虑、躯体化、恐惧、强迫症状和抑郁为主。术前两组阳性项目数及各因子得分无显著差异,观察组阳性项目数、躯体化、强迫症状、抑郁、焦虑得分明显低于对照组(P<0.05)。T1期两组血压、心率、血糖均呈现上升,T1～T4两组均存在波动,观察组波动幅度小于对照组(P<0.05)。结论骨科手术患者术前心理应激状态以焦虑症状为主,术前护理访视能有效降低患者心理应激反应对血压、心率及血糖波动的影响,有利于保证手术顺利进行和术后心理状态恢复。Objective To study the preoperative psychological stress of patients with undergoing orthopedic surgery and the impact of preoperative nursing visiting care on perioperative stress response. Methods One hundred and twen- ty cases of fracture patients were randomly divided into observation group and control group,observation group I day before surgery by the operating room nurse, nursing visits, and compared blood pressure, heart rate and blood sugar changes of the two groups before surgery and during surgery. Results One hundred and twenty cases of orthopedic pa- tients before psychological stress, anxiety, somatization,fear,obsessive-compulsive symptoms and depression-based. Preoperative two sets of positive items and factor score no significant difference between the two groups after positive items and factor score lower number of positive items of the observation group,somatization,obsessive-compulsive symptoms, depression, anxiety score were significantly lower than the control group （P〈0.05）. From T1 the blood pressure,heart rate,blood glucose showed a rise of two groups, T1 to T4 two groups had fluctuations（P〈O.05）, observation group volatil- ity than the control group. Conclusion Psychological stress in patients undergoing orthopedic surgery preoperative the status anxiety symptoms, preoperative nursing rate and blood sugar fluctuaions,is conductive visiting care can reduce cardiac stress reaction on blood pressure, heart to ensure smooth operation and postoperative mental state recovery.

关 键 词：应激反应 围手术期 骨折手术 术前访视 

分 类 号：R472.3[医药卫生—护理学]