心理干预结合针灸疗法对全麻后留置尿管患者的影响

目的：探讨心理干预结合针灸疗法对全麻后留置尿管患者围术期血流动力学及苏醒期躁动的影响。方法：择期在全身麻醉下行腰椎间盘摘除术的60例患者（ASA,Ⅰ-Ⅱ级）随机分为心理干预组（A组,n=30）和对照组（B组,n=30）。2组患者均在全身麻醉后留置尿管,均接受常规围术期护理,A组患者在此基础上实施心理干预,术后结合针灸疗法。监测并记录2组患者在术前1d（T1）、入室后麻醉前（T2）、拔管后15min（T3）、拔管后30min（T4）的心率（HR）、平均动脉压（MAP）的变化及2组患者苏醒期躁动评分情况。结果：2组患者在T3与T1比较,HR和MAP均升高,2组患者在T2、T3、T4时,组间比较有统计学意义（P〈0.05）;2组患者苏醒期躁动评分有统计学意义（P〈0.05）。结论：心理干预结合针灸疗法能够保证全麻后留置尿管患者围术期血流动力学的稳定,降低苏醒期躁动的发生。

The Effects of Psychological Intervention Combined with Acupuncture on Patients with Urinary Catheter after General Anesthesia

Objective：To explore the effect of psychological intervention combined with acupuncture treatment on blood flow dynamics in peri-operative period and restlessness score in waking-up period for patients with urinary catheter after general anesthesia. Methods： Sixty patients who received Resection of Lumbar Intervertebral Disc （ASA, level I to II） under general anesthesia were randomly divided into psychological intervention group （group A, n=30） and control group （group B, n=30）. Patients in both groups had urinary catheter after general anesthesia, and received perioperative nursery. Patients in group A received extra psychological intervention and acupuncture treatment after surgeries. The changes of heart rate （HR） and mean arterial blood pressure （MABP） 1 day before the surgery （T1）, before anesthesia（T2）, 15 minutes after extubation （T3）, 30 minutes after extubation （T4） as well as the restlessness sore in waking-up period were observed and recorded. Results： Compared with T3 and T1, there were increase in HR and MABP for patients in both groups. During the phases of T2, T3 and T4, the two groups showed significant differences （P0.05）. There were significant differences in restlessness scores in waking-up period between the two groups （P0.05）. Conclusion： Psychological intervention combined with acupuncture treatment could guarantee the stability of blood flow dynamics in peri-operative period and reduce the restlessness sore in waking-up period for patients with urinary catheter after general anesthesia.