心理干预对剖宫产术中应激反应的影响

[目的]观察心理干预对剖宫产术中应激反应的影响。[方法]将60例ASAⅠ~Ⅱ级择期剖宫产患者随机分成观察组(A)和对照组(B),每组30例。B组:麻醉医师在术前访视时,向产妇介绍手术麻醉经过和术中注意事项,解答产妇的相关疑虑。A组:在B组基础上,带产妇进手术室熟悉手术环境,手术期间其丈夫在手术室全程陪同。A、B两组分别在入室(T1)、硬膜外穿刺成功(T2)、胎儿取出(T3)、术毕(T4)时抽静脉血测血糖(BS)、皮质醇(CORT),并记录相应时刻的视觉模拟焦虑评分(VAS)和平均动脉压(MAP)、心率(HR)。[结果]两组T3、T4时的BS、CORT均显著高于T1时(P<0.05),组间各相应时刻的差异无显著性(P>0.05)。A组各时刻的VAS值差异无显著性(P>0.05);B组T2、、T3、T4时的VAS值均显著高于T1时(P<0.01),且较A组相应时刻升高(P<0.05)。两组各时刻的MAP、HR差异无显著性(P>0.05)。[结论]心理干预能有效减轻产妇的术中焦虑,但对应激激素水平改善不明显。

Influence of psychological interference to stress reaction in cesarean section

[Objective]To observe the influence of psychological interference to stress reaction in Caesarean section. [Methods]Sixty cases of hospitalized women in Grade ASA III waiting for Cesarean section were equally divided into two groups: observation group (A) and reference group (B). For reference group (B) anaesthetist visited the lying-in women introduced the anaesthesia process and attentions during the operation before operation. For group (A), besides what the anaesthetist told the reference group (B), the anaesthetist took the lying-in women into the operation room and made them familiar with the environment of the operation room. Besides, their husbands accompanied them during their operations. time when patient entered the operation room (T1), time when epidural piercing succeeded (T2), time when embryo was taken out (T3), time when the operation ended (T4) and vein blood was taken to test for blood sugar (BS) and corticosteriod (CORT), were all recorded together with the corresponding verbal angst scale (VAS) and the mean artery pressure (MAP) and heart rate (HR) .[Results]BS and CORT of both group were obviously higher at T3, T4 than at T1 (P<0.05). The difference between the two groups was not significant (P>0.05). For VAS: in group A the difference among T1, T2, T3, T4 was not significant (P>0.05), in group B, VAS was obviously higher at T2, T3, T4than at T1(P<0.01), and VAS was higher in group B than in group A (P<0.05). For both group their MAP, HR difference at T1, T2, T3 and T4 was not significant (P>0.05). [Conclusion]Psychological interference can reduce the anxiety of the lying-in women in cesarean section effectively, but can not improve the stimulation hormone level obviously.