国际麻醉学与复苏杂志   2023, Issue (4): 0-0
    
非药物干预对腹腔镜子宫切除术患者围手术期 焦虑和疼痛的影响
颜楠, 杨保仲, 杨彩霞, 吴高辉, 井子夜, 郭祺, 张艳鹏1()
1.山西医科大学
Effect of non‑pharmacological interventions on perioperative anxiety and pain in patients undergoing laparoscopic hysterectomy
 全文:
摘要:

目的 探讨非药物干预对腹腔镜子宫切除术患者围手术期焦虑和疼痛的影响。 方法 选取2021年10月至2022年4月在山西医科大学第一医院择期行腹腔镜子宫切除术的患者80例,按随机数字表法分为常规访视及治疗组(对照组)和联合干预组(试验组),每组40例。对照组接受常规术前访视及围手术期治疗和监护,试验组在对照组的基础上接受线上微信的术前访视、音乐干预及芳香疗法3种非药物方法联合干预。比较两组患者术前访视时(T0)、入手术室后(T1)、术后4 h(T2)时MAP、心率、焦虑自评量表(Self‑rating Anxiety Scale, SAS)评分、VAS疼痛评分、IL‑6水平,比较两组患者出院前(T3)总体幸福感量表(General Well‑being Scale, GWB)评分。 结果 试验组T1、T2时MAP、心率、SAS评分、IL‑6水平低于对照组(P<0.05),T2时VAS疼痛评分低于对照组(P<0.05)。与T0比较:对照组T1、T2时MAP、心率、IL‑6水平均升高(P<0.05),T1时SAS评分、VAS疼痛评分均升高(P<0.05);试验组T1时心率和T2时MAP、心率均升高(P<0.05),T2时SAS评分降低(P<0.05),T1、T2时IL‑6水平均升高(P<0.05);两组患者T2时VAS疼痛评分均升高(P<0.05)。与T1时比较:对照组T2时MAP、心率降低(P<0.05),试验组T2时心率升高(P<0.05);两组患者T2时VAS疼痛评分、IL‑6水平均升高(P<0.05),SAS评分均降低(P<0.05)。试验组T3时GWB评分高于对照组(P<0.05)。 结论 在常规术前访视的基础上,3种非药物方法联合干预可以显著缓解腹腔镜子宫切除术患者的围手术期焦虑及疼痛,降低应激水平,提升围手术期舒适度。

关键词: 非药物治疗; 腹腔镜子宫切除术; 焦虑; 疼痛; 应激
Abstract:

Objective To investigate the effect of non‑pharmacological interventions on perioperative anxiety and pain in patients undergoing laparoscopic hysterectomy. Methods A total of 80 patients who underwent elective laparoscopic hysterectomy at the First Hospital of Shanxi Medical University from October 2021 to April 2022 were selected. According to the random number table method, they were divided into two groups (n=40): a routine preoperative visit (control) group and a combined intervention (experimental) group. The control group received routine preoperative visit followed by perioperative treatment and monitoring, while the experimental group received three non‑pharmacological treatments: preoperative visits through online WeChat communication, music intervention and aromatherapy, in addition to those in the control group. Both groups were compared for mean arterial pressure (MAP), heart rate, Self‑rating Anxiety Scale (SAS) scores, Visual Analogue Scale (VAS) scores and interleukin‑6 (IL‑6) levels at the preoperative visit (T0), after entering the operating room (T1) and at postoperative 4 h (T2). The two groups were also compared for the General Well‑being Scale (GWB) scores before discharge (T3). Results Compared with the control group, the experimental group showed decreases in MAP, heart rate, SAS scores, and IL‑6 levels at T1 and T2 (P<0.05), and decrease in VAS scores at T2 (P<0.05). Compared with those at T0, the control group presented increases in MAP, heart rate and IL‑6 levels at T1 and T2 (P<0.05), increases in SAS scores and VAS scores at T1 (P<0.05); while the experimental group showed increases in heart rate at T1, increases in MAP and heart rate at T2 (P<0.05), decreases in SAS scores at T2 (P<0.05), and increases in IL‑6 levels at T1 and T2 (P<0.05); VAS scores increased at T2 in both groups (P<0.05). Comparison with those at T1, the control group showed decreased MAP and heart rate at T2 (P<0.05), the experimental group presented increased heart rate at T2 (P<0.05); increases in VAS scores and IL‑6 levels (P<0.05) as well as decreases in SAS scores (P<0.05) were seen at T2 in both groups. The GWB score at T3 in the experimental group was higher than that in the control group (P<0.05). Conclusions Based on routine preoperative visit, the three non‑pharmacological interventions can significantly relieve perioperative anxiety and pain, reduce stress, and enhance perioperative comfort in patients undergoing laparoscopic hysterectomy.

Key words: Non‑drug treatment; Laparoscopic hysterectomy; Anxiety; Pain; Stress