放松式心理干预联合麻醉苏醒护理在颈丛神经阻滞麻醉下甲状腺手术患者中的应用效果  

Effect of relaxation psychological intervention combined with anesthesia awakening care in cervical plexus block anesthesia patients under thyroid surgery

作　　者：段静静 何佳佳 李晔彤 翟盛楠[1] 马烁 DUAN Jingjing;HE Jiajia;LI Yetong;ZHAI Shengnan;MA Shuo(First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院,河南省郑州市450000

出　　处：《护理实践与研究》2024年第6期879-885,共7页Nursing Practice and Research

基　　金：河南省卫生健康委员会医学科技攻关省部共建重点项目(编号:SBGJ202103059)。

摘　　要：目的 探讨放松式心理干预联合麻醉苏醒护理在颈丛神经阻滞麻醉下甲状腺手术患者中的应用效果。方法 选取医院2019年11月—2021年11月在颈丛神经阻滞麻醉下行甲状腺手术患者97例,按放松式心理干预联合麻醉苏醒护理实施时间分组,将2019年11月—2020年11月实施放松式心理干预联合麻醉苏醒护理前纳入的48例患者设为对照组,将2020年12月—2021年11月实施放松式心理干预联合麻醉苏醒护理后纳入的49例患者设为观察组,对照组采取常规护理,观察组进行放松式心理干预联合麻醉苏醒护理,比较两组干预前后心理状态、疼痛情况、依从性、生活质量及不良反应发生情况。结果干预前,两组焦虑自评量表(SAS)及抑郁自评量表(SDS)评分比较差异无统计学意义(P>0.05);干预后,观察组患者SAS和SDS评分低于对照组,差异有统计学意义(P<0.05)。两组NRS评分存在时间效应、组间效应、时间与组间的交互作用,差异有统计学意义(P<0.05);其中,观察组术后1 h、术后4 h及术后12 h时的NRS评分均低于对照组,差异有统计学意义(P<0.05),两组术后1 h、术后4 h及术后12 h时的NRS评分较术前均下降,差异有统计学意义(P<0.05)。干预后,观察组Morisky服药依从性量表中服药依从性高于对照组,差异有统计学意义(P<0.05)。干预后,观察组生理功能、活力、精神健康、生理职能、情感职能、躯体疼痛及总体健康评分均高于对照组,差异有统计学意义(P<0.05)。干预期间,观察组不良反应发生率为4.08%,低于对照组的18.75%,两组比较差异有统计学意义(P<0.05)。结论 放松式心理干预联合麻醉苏醒护理对颈丛神经阻滞麻醉下的甲状腺手术患者可缓解焦虑、抑郁,减轻疼痛程度,提高依从性,改善生活质量,降低不良反应发生率。Objective To explore the application effect of relaxation psychological intervention combined with anesthesia awakening care in patients underwent thyroid surgery with cervical plexus block anesthesia.Methods 97 patients undergoing thyroid surgery under cervical plexus nerve block anesthesia from November 2019 to November 2021 were selected and divided into groups according to the implementation time of relaxation psychological intervention combined with anesthesia resuscitation care.48 patients included before relaxation psychological intervention combined with anesthesia resuscitation care from November 2019 to November 2020 were set as the control group.49 patients included after relaxation psychological intervention combined with anesthesia resuscitation care from December 2020 to November 2021 were set as the observation group.The control group received routine care,and the observation group underwent relaxation psychological intervention combined with anesthesia resuscitation care.The psychological state,pain condition,compliance,quality of life and adverse reactions before and after the intervention were compared between the two groups.Results Before the intervention,there was no statistically significant difference between the SAS and SDS scores of the two groups(P>0.05).After the intervention,the SAS and SDS scores of the observation group were lower than that of the control group,and the difference was statistically significant(P<0.05).There were time effects,intergroup effects,and interactions between time and group,and the difference was statistically significant(P<0.05).The NRS score at 1 h,4 h,and 12 h after surgery in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).The NRS score at 1 h,4 h,and 12 h after surgery in the two groups was lower than that before surgery,and the difference was statistically significant(P<0.05).After the intervention,the compliance of the Morisky medication administration scale of the observation group was

关 键 词：甲状腺手术 颈丛神经阻滞 放松式心理干预 麻醉苏醒护理 心理状态 疼痛 

分 类 号：R473.6[医药卫生—护理学]