心理抚慰对甲状腺肿瘤患者手术中等待病理结果时情绪的影响

目的探讨心理抚慰对甲状腺肿瘤患者术中等待病理冰冻切片时情绪的影响。方法选取2008年1月—2009年12月在我院择期行甲状腺肿瘤手术切除的患者120例。入院后被随机分为两组各60例,A组为心理抚慰组;B组为对照组。采用问卷调查法,用状态-特质焦虑量表（STAI）评估患者手术前和手术中的焦虑程度,观察患者的心率、收缩压、呼吸频率的变化,以及术中不良反应的发生情况。结果手术前,两组患者均有不同程度的焦虑情绪;手术中,B组患者的焦虑程度在等待病理冰冻切片的过程中加重,S-AI和T-AI分值增加明显,A组患者的S-AI和T-AI分值虽有增加,但与术前相比差异无统计学意义,两组比较,差异有统计学意义（P〈0.05）。A组在心率、收缩压和呼吸频率变化方面与B组比较,差异有统计学意义（P〈0.05）。B组术中发生头晕、恶心、胸闷等不良反应18例,占30.0%,术中术后伤口渗血5例,占8.3%。A组术中发生不良反应6例,占10.0%,术中术后伤口渗血2例,占3.3%,两组比较差异有统计学意义（P〈0.05）。结论对甲状腺手术患者实施心理抚慰,能有效缓解患者在等待病理冰冻切片时的焦虑情绪、稳定生命体征和降低手术不良反应的发生,以保证手术的顺利进行。

Effect of psychological comfort on intraoperative emotion of the patients with thyroid tumor awaiting frozen pathologic section report

Objective To probe into the effect of psychological comfort on intraoperative emotion of the patients with thyroid tumor awaiting frozen pathologic section report.Methods A total of 120 patients who were scheduled for elective thyroidectomy from January 2008 to December 2009 were randomly divided into the control group（n=60） and psychological comfort group（n=60） after admission to our hospital.The control group was provided with routine nursing.As for the psychological comfort group,except routine nursing,special nursing intervention was given before and during the operation.State-Trait Anxiety Inventory（STAI） was used to evaluate the patients′ anxiety degree before and during the operation.The changes in heart rate,systolic pressure and respiratory frequency before and during the operation,as well as the occurrence of adverse events during the operation were observed.Results All the patients presented anxiety of different degrees before the operation.During the operation,S-AI value and T-AI value of patients in the control group increased obviously awaiting frozen pathologic section report,compared with those before operation（P〈0.05）.S-AI and T-AI values of patients also increased in the psychological comfort group,but were not significantly different from those before operation.There were significant differences in S-AI value,T-AI value,heart rate,systolic pressure and respiratory frequency between the two groups awaiting frozen pathologic section report（P〈0.05）.In the control group,the adverse events such as dizziness,nausea,chest tightness occurred in 18 cases（30%） during the operation and bleeding wounds occurred in 5 cases（8.3%）.In the psychological comfort group,there were 6 cases（10%） with adverse events and 2 cases（3.3%） with bleeding wounds,significantly different from the control group（P〈0.05）.Conclusion The application of psychological comfort in patients with thyroid tumor awaiting frozen pathologic section report can effectively release their anxiety,stabilize their vital signs,and reduce occurrence of adverse events during the operation to ensure a smooth operation.