心理干预对中老年全麻病人导尿术后麻醉苏醒期躁动的影响

目的 探讨心理干预对中老年全麻病人导尿术后麻醉苏醒期躁动的影响.方法 选择60例气管插管全麻下行开胸手术病人,随机分为3组,每组各20例.Ⅰ组20例是在手术晨病人清醒状态下行导尿术.Ⅱ组20例是在病人全麻后行导尿术,Ⅲ组20例是在病人进入手术间后,由巡回护士对病人进行心理干预,讲解麻醉前、后插尿管的情况,及麻醉后留置尿管的优点及必要性,并详细解释留置尿管后,在麻醉苏醒过程中因尿管刺激而存在不适等.取得病人的理解和合作后,在麻醉后行导尿术.观察各组病人安置尿管时的心率、血压变化,一次性置管成功率以及麻醉苏醒期病人躁动等情况.结果 Ⅰ组:心率、血压均明显增加,一次性置管成功率80%(P<0.05),麻醉苏醒躁动分值及导管脱出率无显著性差异(P>0.05).Ⅱ组:心率、血压平稳,一次性置管成功率100%(P>0.05),麻醉苏醒躁动分值及导管脱出率增加(P<0.01).Ⅲ组:各项指标变化无显著性差异(P>0.05).结论 心理干预可以明显减轻中老年全麻导尿病人苏醒期躁动,而且在麻醉后行导尿术,可提高导尿的成功率,减轻病人的痛苦,体现出"一切为了病人"和"以病人为中心"的服务宗旨.

The effect of psychological intervention on restlessness in elderly patients in the recovery period of general anesthesia after catheterization

Objective To investigate the effect of psychological intervention on the restlessness in elderly patients in anesthesia recovery period after the inducement of urethral catheterization. Methods 60 patients, undergoing general anesthesia trachea intubation for open chest operation, were randomly allocated to three groups. 20 patients for each. In the first group, 20 patients were catheterized before the inducement of general anesthesia;In the second group, catheter was inserted after the inducement of general anesthesia. Whereas the patients in the third group were received psychological intervention by circuit nurses after entering the operation room. The patients were given detail explanations of catheterization before and after the inducement of general anesthesia , of the advantages and necessity of intubations after anesthesia, and of the discomfort of intubations during the anesthesia recovery period because of the catheter stimulation. With the understanding and cooperation of the patients, catheter was inserted after the inducement of general anesthesia. Of all the three groups, the heart rate and the blood pressure after urethral catheterization, the success rate of catheterization and the restlessness in the recovery period of general anesthesia were closely observed. Results In the first group, the heart rate and the blood pressure were both obviously increased;the success rate of catheterization was 80% (P<0.05) .the restlessness and the rate of catheter pulling - off were no significant difference ( P > 0.05) .In the second group, both the heart rate and the blood pressure were stable;the success rate of catheterization was 100% ( P > 0.05 ) ;but the restlessness and the rate of catheter pulling - off were increased ( P < 0. 01) .In the third group, there was no significant difference in all the items above (P >0. 05) . Conclusions Psychological intervention can obviously ease the restlessness in recovery period of general anesthesia in elderly patients with the catheter inserted;moreover, the inducement of catheterization after anesthesia can enhance the success rate of catheterization and alleviate the pain of patients, representing the patient - centered service tenet.