【摘要】 目的:观察意象对话技术(IDS)对妇科患者术前后血压(blood pressure,BP)和心率(heartrate,HR)的影响,探索减轻术前焦虑的最佳方式。方法:将188例焦虑自评量表(Self-Rating Anxiety Scale,SAS)测评得分大于50的妇科手术病人用随机数字表法分为IDS组、音乐意象放松(MIR)组及对照组。IDS组于术前1d下午给予意象对话心理干预,MIR组于同一时间给予播放自制的MIR录音干预,统计三组干预前及干预后(术前1d、术前0.5h、术后1h、术后12h～24h)的BP和HR,作为疗效评价指标。结果:两个干预组干预前后BP和HR变化均有显著差异:收缩压(systolic pressure,SBP)、舒张压(diastolic pressure,DBP)、HR各指标均明显下降(P<0.010)。干预前与术前0.5hBP和HR比较:IDS组术前HR低于干预前(t=5.734,P=0.000);MIR组术前DBP高于干预前(t=-3.265,P=0.002),术前HR低于干预前(t=2.968,P=0.004)。对照组SBP、DBP高于干预前(P=0.000)。干预前与术后1hBP和HR比较:IDS组SBP、DBP、HR术后1h均低于干预前(P=0.013,P=0.024,P=0.000);MIR组SBP、HR术后1h均低于干预前(P=0.014,P=0.000);对照组HR术后1h均低于干预前(t=5.611,P=0.000)。术后12h～24hBP和HR与干预前比较三组均有下降。结论:IDS和MIR干预对减轻手术前后的心理和生理应激有不同的作用,IDS在稳定BP和HR方面更优于MIR。更多还原

【Abstract】 Objective:Observe what effect does imagery-dialogue skill has on the BP and HR in pre-operation and post-operation. Explore the best way to alleviate the pre-operation anxiety. Methods:188 gynecological operation patients (with SAS scores above 50) were divided into three groups:imagery-dialogue skill(IDS) group,music-imagery-relaxation(MIR) group,and control group. IDS group was given imagery dialogue mental intervention in the afternoon of 1 day pre-operation. MIR group was given intervention of playing self-made relaxation music tape recordings at the same time. Evaluate BP and HR of 3 groups in both pre-intervention and post-intervention (1 day pre-operation,0.5 h pre-operation,1 h post-operation,12 h-24 h after operation) and as index of assessing efficiency.Results:Changes of the BP and HR were significantly distinct between two intervention groups in pre and post-intervention:SBP,DBP and HR all declined apparently (P<0.010).The comparison of BP and HR between pre-intervention and 0.5 h pre-operation:HR of the IDS group in pre-operation was lower than that in pre-intervention (t=5.734,P=0.000); DBP of the MIR group in pre-operation was higher than that in pre-intervention (t=-3.265,P=0.002) and HR in pre-operation was lower than that in pre-intervention (t=2.968,P=0.004).The SBP and DBP of control group in pre-operation were higher than that in 1 day before operation (P=0.000). The comparison of BP and HR between pre-intervention and 1 h post-operation:SBP,DBP and HR of IDS group were lower in 1 h post-operation than that in pre-intervention (P=0.013,0.024,0.000,respectively). The comparison of BP and HR between pre-intervention and 1 h post-operation in MIR group:DBP and HR in 1 h post-operation were lower than that in pre-intervention (P=0.014,0.000). The comparison of BP and HR between pre-intervention and 1 h post-operation in control group:HR were lower in 1 h post-operation than that in pre-intervention (t=5.611,P=0.000). The BP and HR of three groups in 12 h-24 h after operation all declined compared to that in pre-intervention. Conclusion:IDS and MIR intervention have different effects on alleviating psychological and physiological stress of patients in pre-operation,which are still obvious in 1 h post-operation. IDS is better than MIR at stabilizing BP and HR.更多还原