不同类别骨科手术病人围术期睡眠质量及影响因素分析  

Analysis of perioperative sleep quality and influencing factors in different types of orthopedic surgery patients

作　　者：魏晨慧 郭锦丽[1,2] 程宏 王翠萍 史洁 李佳慧 WEI Chenhui;GUO Jinli;CHENG Hong;WANG Cuiping;SHI Jie;LI Jiahui(Shanxi Medical University,Shanxi 030001 China)

机构地区：[1]山西医科大学,山西030001 [2]山西医科大学第二医院

出　　处：《护理研究》2020年第12期2120-2125,共6页Chinese Nursing Research

摘　　要：[目的]探讨不同类别骨科手术病人围术期睡眠质量及影响因素。[方法]选择2019年3月—6月在山西省某三级甲等医院行择期手术的314例成年骨科手术病人作为研究对象,其中四肢骨折84例,关节疾病82例,颈椎疾病78例,腰椎疾病70例,采用匹兹堡睡眠质量指数(PSQI)、阿森斯失眠量表(AIS)、唾液皮质醇(SC)浓度评估病人围术期睡眠质量及其动态变化,并分析导致围术期病人睡眠质量下降的影响因素。[结果]4类骨科手术病人围术期PSQI评分高于入院前(P<0.05);71.43%腰椎疾病病人、60.98%的关节疾病病人、57.14%四肢骨折病人、46.15%颈椎疾病病人在围术期存在不同程度的睡眠问题。3种评估方式均显示腰椎疾病病人围术期睡眠质量最差,颈椎疾病病人睡眠质量相对较好,4类手术病人睡眠质量在围术期存在动态变化。重度疼痛是腰椎疾病病人围术期睡眠质量的主要影响因素,焦虑是四肢骨折、关节疾病病人围术期睡眠质量的主要影响因素。[结论]不同类别骨科手术病人围术期睡眠质量及其影响因素不同,医护人员应结合各类病人睡眠质量变化特征及其影响因素制定个性化防治措施,改善病人睡眠质量,促进病人快速康复。Objective:To probe into the perioperative sleep quality and its influencing factors in patients with different types of orthopaedic surgery.Methods:A total of 314 adult orthopedic patients undergoing selective operation in a tertiary grade A hospital in Shanxi province from March to June 2019,were selected as objects.Among them,there were 84 cases of limb fracture,82 cases of joint disease,78 cases of cervical vertebra disease,and 70 cases of lumbar vertebra disease.Using the Pittsburgh sleep quality index(PSQI),Athens insomnia scale(AIS),and concentration of salivary cortisol(SC),perioperative sleep quality and its dynamic change were evaluated.Then,influence factors that making perioperative sleep quality decline,were analyzed.Results:The perioperative PSQI scores of patients with 4 types of orthopedic surgery were all higher than those before admission(P<0.05).During the perioperative period,71.43%of patients with lumbar vertebra disease,60.98%of patients with joint disease,57.14%of patients with limb fracture and 46.15%of patients with cervical vertebra disease,had different degrees of troubles in sleeping.Three evaluation methods all showed that the perioperative sleep quality of patients with lumbar vertebra disease was the worst,while the sleep quality of patients with cervical vertebra disease was relatively better.In addition,the perioperative sleep quality of patients with 4 different types of surgery existed dynamic changes.Severe pain was the main influencing factor of perioperative sleep quality in patients with lumbar vertebra disease.And anxiety was the main influencing factor of perioperative sleep quality in patients with limb fracture and joint disease.Conclusions:Perioperative sleep quality and its influencing factors were different among patients with different types of orthopedic surgery.Medical staff should formulate personalized prevention and treatment measures combined with the changing characteristics of patients'sleep quality and its influencing factors,so as to improve patients'sleep q

关 键 词：骨科手术 围术期 睡眠质量 影响因素 腰椎疾病 匹兹堡睡眠质量指数 阿森斯失眠量表 唾液皮质醇 

分 类 号：R473.6[医药卫生—护理学]