术前心理干预对全麻患者围术期心理应激反应的影响

目的 探讨术前心理干预对减轻全麻患者围术期应激反应的影响.方法 120例全麻下腹腔镜胆囊手术患者随机分为对照组和干预组,每组各60例,对照组施行常规术前访视,干预组在对照组基础上实施心理干预,比较两组患者干预前、进入手术室后和手术后1d焦虑自评量表（SAS）、状态焦虑询问表（S-SI）评分,观察两组患者血流动力学指标变化,比较两组术后苏醒期躁动反应发生率和舒适度评分.结果 干预组入室后和术后1d时点SAS评分均明显低于对照组（P＜0.01）,入室后干预组S-SI评分明显低于对照组（P＜0.01）;入室后干预组收缩压（SBP）明显低于对照组（P＜0.05）;两组躁动评分比较差异显著（W=3227.50,Z=-2.224,P=0.026）.舒适度评分干预组明显低于对照组（t=3.01,P=0.004）.结论 术前心理干预有利于术中循环功能保持稳定,改善患者术后由应激反应导致的心理反应,减轻全麻苏醒期躁动发生,有利于患者安全顺利度过围术期

The Effect of Preoperative Psychological Intervention on Psychological Stress Reaction of Patients Undergoing General Anesthesia during the Perioperative Period

Objective to observe the effect of preoperative psychological intervention on psycho- logical stress reaction of patients undergoing general anesthesia during the perioperative period. Methods 120 cases of laparoscopic operation under general anesthesia were randomly divided into control group and intervention group with 60 cases of each group.The control group re- ceived the routine preoperative interview and the intervention group took the psychological in- tervention on the basis of the control group.The scores of self rating Anxiety Scale （SAS） and state anxiety questionnaire （S-SI） in the two groups were compared before intervention,after entering operation room and ID after operation. We observed the changes of hemodynamic in- dexes in the two groups and compared the postoperative agitation reaction rate and comfort scores.Results The SAS scores in the intervention group were significantly lower than those in the control group after entering operation room and 1D after operation （P 〈 0. 01 ）. The S- SI scores in the intervention group were significantly lower than those in the control group after entering operation room （P〈0.0I）.The systolic blood pressure （SBP） in the intervention group was significantly lower than that in the control group after entering operation room （P〈0.05）. The scores of agitation in the two groups were significantly different （W=3227.50, Z=-2.224, P=0.026）. The comfort scores in the intervention group were significantly lower than those in the control group （ t = 3.01, P = 0. 004）. Conclusions The preoperative psychological intervention could be beneficial to keep circulation function in operation stable, improve psychological reac- tion caused by stress reaction after operation, reduce the occurrence of restlessness during general anesthesia and help patients pull through the perioperative period.