术前心理护理对术中知晓相关创伤后应激障碍的防治作用研究  

Study for the prevention and treatment effect of intraoperative awareness of post-traumatic stress disorder by preoperative psychological care

作　　者：李向荣[1] 王正英[1] 李英姿[1] 张维[2] 金玉珍[2] 刘艳春[2] 

机构地区：[1]南方医科大学附属深圳市宝安医院,广东深圳518101 [2]广东医学院附属深圳市西乡医院,广东深圳518102

出　　处：《护士进修杂志》2014年第16期1456-1458,共3页Journal of Nurses Training

基　　金：广东省深圳市科技计划项目(医疗卫生类)(编号:201103069)

摘　　要：目的探讨术前心理护理对术中知晓及其相关创伤后应激障碍的防治作用。方法将全麻腹腔镜手术病例术中知晓高危人群585例随机分为观察组290例、对照组295例,对照组进行常规术前和术后整体护理,观察组在此基础上,于术前进行针对术中知晓及其相关创伤后应激障碍的系统心理护理,比较两组间术中知晓及其相关创伤后应激障碍的发生情况。结果 (1)观察组与对照组知晓率差异无显著意义(P>0.05);(2)观察组中知晓病例继发创伤后应激障碍的发生率显著低于对照组,差异有显著意义(P<0.05),且观察组患者创伤后应激障碍自评量表PTSD-SS评分低于对照组,差异有显著意义(P<0.05)。结论术前心理护理可以减低知晓相关创伤后应激障碍的发病率及病情的严重程度,术中知晓相关创伤后应激障碍具有较好的预防作用。Objective To study the prevention and treatment effect of intra operative awareness of post-traumatic stress disorder（PTSD）by preoperative psychological care Method 585 patients with laparoscopic surgery under general anaesthesia and high risk factors of intraoperative awareness was selected and randomly divided into two groups, 290 patients in observing group and 295 patients in control group. Patients in control was given routine preoperative and postoperative holistic nursing. Patients in observing group was given routine holistic nursing and a series of tar geted psychological nursing interventions. The incidence rate of intra-operative awareness, PTSD were measured and compared between two groups. Result There was no significant difference in incidence rates of intraoperative awareness between two groups（xz= 0. 340,P= 0. 632）. There were lower incident rate of post-traumatic stress disorder（x2= 7. 320, P = 0. 007）, lower average score of post traumatic stress disorder self scores （PTSD-SS）（ t = -18.28, P= 0. 000）in observing group than that of in control group. Conclusion Preoperative psychological nursing could not reduce effectively the incidence of intraoperative awareness, but it could reduce the incidence and the severity of PTSD. There is a good clinical effect to improve the awareness of PTSD following by preoperative psychologi- cal nursing intervention.

关 键 词：全身麻醉 创伤后应激障碍 心理护理 

分 类 号：R471[医药卫生—护理学]