音乐干预对心脏介入术中患者心血管指标的影响

目的探讨耳挂式耳机连接MP3音乐干预对心脏介入术中患者平均动脉压（MaP）、心率（HR）、呼吸频率（RR）、经皮血氧饱和度（SpO2）的影响。方法将60例心脏介入术患者按手术时间顺序分为对照组和实验组各30例。对照组采用常规护理，实验组在常规护理基础上增加音乐干预。监测两组患者术前3d（To）、进入导管室至麻醉效果确定未播放音乐（T1）、手术开始11min内（T2）、手术开始第11分钟至结束（T3）MAP、HR、RR、SpO2的平均值和呼吸力学的变化情况。结果与R比较，对照组患者MAP在T1、T2、T3各时段明显升高，差异有统计学意义（105．7±10．8），（123．5±17．8），（125．1±18．5），（110．9±10．5）mmHg，F=5．11，P〈0．05]；HR、RR在T1、T2、T3各时段明显升高，差异有统计学意义（P〈0．05）；实验组患者MAP、HR在T1、T2时段同样升高，但T2升高的幅度低于T1，也低于对照组对应时段，且至T3时段已基本恢复到T0水平。两组MAP比较在T2时段差异有统计学意义（125．1±18．5）mmHg比（114．1±15．6）mmHg，t=2．55，P〈0．05]，在T3时段比较差异也有统计学意义（P〈0．05）；HR、RR两组比较在T2、T3时段差异均有统计学意义（P〈0．05）；两组患者SpO2在各时段差异无统计学意义（P〉0．05），但在T2、T3时段，对照组有3例因紧张憋气而致瞬间SpO2下降至80％左右，实验组患者均呼吸较平稳，两组比较，差异有统计学意义（X2=2．73，P〈0．05）。结论在心脏介入术中应用耳挂式耳机连接MP3音乐干预可降低术中医源性噪音的不良刺激，有效维持患者MAP、HR、RR、SpO2的稳室，提高医疗护理质量。

Effect of music intervention on cardiovascular indexes of patients during cardiac interventional therapy

Objective To study the effect of music intervention through supra-aural earphone connected to MP3 on MAP, HR, RR and SpO2 of patients during cardiac interventional therapy.Methods 60 patients undergone cardiac intervention were randomly divided into control group (30cases) and experimental group (30 cases) according to operation time order. During the operation, traditional care was applied in control group and music intervention on the basis of traditional care was applied in experimental group. The changes of MAP, HR, RR and SpO2 and breathing mechanics were observed during four periods: 3 days before operation(T0), enter the operating room and anesthetic efficacy was definite and without music(T1), the first 11 min of operation (T2), and from the 11th min to the end of the operation (T3).Results In the control group, as compared to T0, MAP increased in T1, T2 and T3, the difference was statistically significant the values were (105.7±10.8),(123.5±17.8),(125.1±18.5),(110.9±10.5)mm Hg, respectively, F=5.11, P＜0.05]. The values of HR and RR markedly increased in T1, T2 and T3 compared with T0 and the differences were statistically significant (P＜0.05). The values of MAP and HR also went up in T1 and T2 in experimental group, but the increase amplitude in T2 was obviously lower than that in T1 and that in control group, and the values in T3 nearly returned to the level in T0. Significant differences were found in MAP of T2 (125.1±18.5)mm Hg vs (114.1±15.6)mm Hg,t=2.55,P＜0.05] and T3 as well(P＜0.05). Compared with themselves in each period, the values of SpO2 in the two groups had no significant differences(P>0.05). However, 3 patients' value of SpO2 decreased to 80% in control group on the account of tense breath holding. On the contrary, the respiration of patients in experimental group was much steadier. There was statistical difference between the two groups(χ2=2.73,P ＜0.05).Conclusions Application of music intervention in cardiac interventional therapy may degrade the stimulus of iatrogenic noise and maintain the equability of MAP, HR, RR and SpO2, and thus promote medical care quality.