【摘要】 目的探讨心理干预对老年腹腔镜胆囊切除术(LC)患者不同时期应激状态及术后恢复的影响。方法采用方便取样法选取2014年8月至2015年7月入住西安交通大学第一附属医院肝胆外科62例老年LC患者为研究对象,随机分干预组和对照组,各31例。对照组患者给予常规护理,干预组患者给予常规护理的同时依据患者不同治疗时期的心理特点,给予心理干预。分别于手术前1天(D-1)、手术当天(D0)麻醉清醒后、术后第2天(D2)收集患者心率、血压、血促肾上腺皮质激素(ACTH)水平、焦虑/抑郁水平、首次下床活动时间、首次肠道排气时间,比较两组患者之间的差异。结果干预组在第D-1、D0、D2天,心率、血压、血ACTH水平、焦虑/抑郁水平、手术后4 h伤口疼痛强度低于对照组;首次下床活动时间、首次肠道排气时间,早于对照组。差异有统计学意义(P<0.05)。结论心理干预能有效缓解老年腹腔镜胆囊切除术患者不同时期的应激状况,可以促进术后早期恢复,值得临床推广。更多还原

【Abstract】 Objective To explore the effects of psychological intervention on stress reaction during different operation period and postoperative recovery in elderly patients with laparoscopic cholecystectomy(LC).Methods Selected 62 cases of elderly patients with different biliary tract disease from the Department of Hepatobiliary Surgery of First Affiliated Hospital of Xi’an Jiao Tong University during July 2015 to August 2014.Patients were randomly divided into two groups with 31 cases in each group: the intervention group and the control group.The control group received routine nursing procedure,while the intervention group received routine nursing care plus the psychological intervention at the same time.The heart rate,blood pressure,blood ACTH level and anxiety level were measured on the first pre-operation day(D-1),surgery day(D0),anesthetic awareness and second day post-operation(D2); and the first off-bed activity,the first intestinal exhaust time postoperation were also compared between two groups.Results The heart rate,blood pressure,blood ACTH levels,anxiety level of D-1,D0,D2 in the intervention group were lower than that in the control group.More importantly,the wound pain intensity at 4 hous after operation is lighter than that of control group; the first off-bed activity and the first intestinal exhaust time are earlier than that of control group.All the difference is statistically significant(P<0.05).Conclusion The psychological intervention can effectively relief the anxiety state of elderly patients undergoing laparoscopic cholecystectomy,and can promote the process of postoperative recovery.更多还原