心理干预对微创经椎间孔腰椎椎间融合术患者心理状态及恢复的影响  

Effects of psychological intervention on psychological states and postoperative recovery of patients after transforaminal lumbar interbody fusion

作　　者：杨艳 杨巧惠 杨芳 薛为高 卞娜[2] 高浩然[2] 马琼[2] 孙赟 

机构地区：[1]武警陕西省总队医院骨科,西安市710054 [2]第四军医大学唐都医院骨科,陕西省西安市710038

出　　处：《中华全科医学》2015年第10期1661-1663,共3页Chinese Journal of General Practice

基　　金：国家自然科学基金(81201633)

摘　　要：目的观察并总结术前心理干预对经Quadrant通道下行微创经椎间孔腰椎椎间融合技术(TLIF)手术患者术前心理状态及术后各项指标恢复的影响和临床效果。方法将2010年1月—2014年1月384例于武警陕西省总队医院住院诊断为腰椎系统相关疾病,并行经Quadrant通道下微创TLIF手术治疗的患者,随机分为2组:护理干预组(实验组)和常规骨科护理组(对照组)。记录、分析、比较2组患者于入院及术前各心理指标及术后身体各指标情况。结果所有患者均至少随访至术后6月;护理干预组术前焦虑SAS:(52.51±3.70)分、术后疼痛VAS:(6.78±1.06)分,明显低于对照组SAS:(56.42±4.04)分、VAS:(7.82±0.88)分(P<0.05)。首次下地时间(3.13±1.02)d,使用镇痛药物次数(1.08±0.22)次,并发症等情况也明显优于对照组[(4.78±1.28)d;(1.89±0.73)次]。结论心理干预在经Quadrant通道下微创TLIF手术中起到了确切且有效的作用,能够有效地缓解患者的焦虑等不良情绪,并对术后患者的恢复起到良性促进作用,在临床工作中应当进一步的推广和采用。Objective To observe and summarize effects of preoperative psychological intervention on the psychological states and postoperative recovery of patients undergoing transforaminal lumbar interbody fusion （TLIF）. Methods From Jan. 2010 to Jan. 2014,384 patients undergoing transforaminal lumbar interbody fusion in our hospital were randomly divided into two groups：the group of nursing intervention （the experimental group） and the group of routine nursing care （control group）. Preoperative anxiety and depression, frequency of heartbeat, blood pressure and index of postoperative recovery were monitored. Results All patients were followed up at least 6 months after the operation. The anxiety （ SAS ： 52.51± 3.70）in the morning before the operation and postoperative pain（ VAS ：6.78 ±1.06） were reduced as compared with those in the control group （ SAS ： 56.42 ± 4. 04, VAS ： 7.82 ± 0. 88, respectively）, P 〈 0.05. The time to walk [ （3.13 ± 1.02） d ] and times of using analgesic drugs（ 1.08 ± 0. 22） were shorten as compared with the control group （4.78 ± 1.28;1.89 ±0. 73 ）, P 〈 0. 05. The incidence of complication was lower in the experimental group. Conclusion The psychological intervention can play a significant role in reducing preoperative anxiety and accelerating postoperative recovery which should be further promoted and used in clinical work.

关 键 词：心理干预 TLIF 焦虑 

分 类 号：R395.1[哲学宗教—心理学] R687.42[医药卫生—医学心理学]