术前心理护理对老年骨科患者术中麻醉及应激的影响  

Effect of preoperative psychological nursing on intraoperative anesthesia and stress in elderly orthopedic patients

作　　者：苏咏梅[1] 梁秋娴[1] 郑嫦娟[1] Su Yong-mei;Liang Qiu-xian;Zheng chang-juan(Anesthesia Surgery Center,Jiangmen Central Hospital,Jiangmen,Guangdong 529000,China)

机构地区：[1]江门市中心医院麻醉手术中心

出　　处：《现代医学与健康研究电子杂志》2019年第5期4-6,共3页Modern Medicine and Health Research

摘　　要：目的 2017年6月至12月收治的98例行快速康复治疗的老年骨科患者,随机分为对照组和观察组,各49例。对照组采用术前常规护理,观察组采用术前心理护理。采用警觉镇静评分(OAA/S)评估并比较两组患者术中唤醒后5、10 min的镇静效果;采用视觉模拟镇痛评分(VAS)评估并比较两组患者术中唤醒后5、10 min的镇痛效果;监测并比较两组患者心率(HR),采用出苏醒室标准(Aldrete)评分量表评估并比较两组患者麻醉效果;采用酶联免疫法检测并比较两组患者血清皮质醇、血量儿茶酚胺;采用自制调查问卷评估并比较两组患者的护理满意度。结果唤醒后5、10 min,两组OAA/S和VAS评分比较,差异均有统计学意义(P <0.05);两组心率和Aldrete评分比较,差异均有统计学意义(P<0.05)。观察组肾上腺素、血管紧张素、血清皮质醇、血浆儿茶酚胺各指标均低于对照组,差异有统计学意义(P <0.05)。观察组满意度高于对照组,对比统计学意义显著(P <0.05)。结论对老年骨科患者快速康复术前予以有效的心理护理干预,可显著改善患者的镇痛镇静效果,降低患者的应激反应,提高患者护理满意度。Objective To investigate the effects of psychological nursing intervention on the anesthetic effect and stress state of elderly orthopedic patients during rapid rehabilitation.Methods A total of 98 elderly orthopedic patients who underwent rapid rehabilitation in Jiangmen Central Hospital from June to December 2017 were randomly divided into control group and observation group,with 49 cases in each group.The control group received routine preoperative care,and the observation group used preoperative psychological care.The sedative effect of 5 years and 10 minutes after atrial arousal was evaluated by the alert sedation score(OAA/S).The visual analog analgesia score(VAS)was used to evaluate and compare the two groups of patients 5 to 10 min after the arousal.The analgesic effect was monitored and compared between the two groups(HR).The anesthesia effect was evaluated and compared between the two groups.The serum cortisol was measured and compared between the two groups by enzyme-linked immunosorbent assay.Blood catecholamines;self-made questionnaires were used to evaluate and compare the satisfaction of the two groups of patients.Results At 5 and 10 min after arousal,the differences of OAA/S and VAS scores were statistically significant(P<0.05).There were significant differences in heart rate and Aldrete score between the two groups(P<0.05).The indexes of adrenaline,angiotensin,serum cortisol and plasma catecholamine in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).The satisfaction of the observation group was higher than that of the control group,and the statistical significance was significant(P<0.05).Conclusion Effective psychological nursing intervention for rapid rehabilitation of elderly orthopedic patients can significantly improve the analgesic and sedative effect of patients,reduce the stress response of patients and improve the satisfaction of patients.

关 键 词：心理护理 老年骨科患者 麻醉效果 应激状态 

分 类 号：R473.6[医药卫生—护理学]