| 成剑文,莫春丽,罗宇文,张元涛,朱艺麟,陈 斌.术前心理沟通疏导对人工膝关节置换术患者应激反应、心理状态及术后疼痛的影响[J].,2020,(11):2089-2093 |
| 术前心理沟通疏导对人工膝关节置换术患者应激反应、心理状态及术后疼痛的影响 |
| Effects of Preoperative Psychological Communication and Counseling on Stress Response, Psychological State and Postoperative Pain of Patients Undergoing Prosthetic Knee Arthroplasty |
| 投稿时间：2019-11-21 修订日期：2019-12-16 |
| DOI：10.13241/j.cnki.pmb.2020.11.018 |
| 中文关键词: 人工膝关节置换术 术前心理沟通疏导 应激反应 心理状态 疼痛 |
| 英文关键词: Prosthetic knee arthroplasty Preoperative psychological communication and counseling Stress response Psychological state Pain |
| 基金项目:广东省医学科学技术研究基金项目（A20170363）； 2017年汕头市科技计划医疗卫生类别课题项目（180404094011025） |
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| 中文摘要: |
| 摘要 目的：分析术前心理沟通疏导对人工膝关节置换术患者应激反应、心理状态以及术后疼痛的影响。方法：选取2018年1月～2019年1月汕头大学医学院第一附属医院和南方医科大学附属东莞市人民医院收治的拟行人工膝关节置换术的患者89例，以随机数字表法分为术前干预组和常规手术组，常规手术组按常规行术前患者教育，术前干预组行术前心理沟通疏导，比较两组术后康复情况、应激反应，采用抑郁自评量表（SDS）评分、焦虑自评量表（SAS）评分、视觉模拟评分（VAS）以及简化的McGill问卷（SF-MPQ）评价患者的抑郁、焦虑、疼痛情况。结果：术前干预组术后2周膝关节活动度（ROM）、膝关节特种外科医院（HSS）评分高于常规手术组（P＜0.05）；术前干预组术后即刻醛固酮（ALD）、血管紧张素Ⅱ（AngⅡ）、去甲肾上腺素（NE）水平低于常规手术组（P＜0.05）；术前干预组出院时SDS评分、SAS评分低于常规手术组（P＜0.05）；术前干预组术后VAS评分、SF-MPQ评分低于常规手术组（P＜0.05）。结论：术前心理沟通疏导能够明显减轻接受人工膝关节置换术治疗的患者的应激反应，改善不良情绪，减轻术后疼痛感，促进患者康复。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the effects of preoperative psychological communication and counseling on stress response, psychological state and postoperative pain of patients undergoing prosthetic knee arthroplasty. Methods: From January 2018 to January 2019, 89 patients with prosthetic knee arthroplasty were selected from First Affiliated Hospital of Shantou University Medical College and Dongguan People's Hospital Affiliated to Southern Medical University. They were divided into preoperative intervention group, routine operation group by random number table method. The routine operation group received preoperative education of patients, while the preoperative intervention group received preoperative psychological communication and counseling. Postoperative rehabilitation and stress response were compared between the two groups. Self-rating depression scale (SDS), Self-rating anxiety scale (SAS), Visual Analogue Scale(VAS) and Simplified McGill Questionnaire(SF-MPQ) were used to evaluate depression, anxiety and pain. Results: The range of motion rom(ROM) and Hospital for special surgery(HSS) scores of knee joint in preoperative intervention group were higher than those in routine operation group at 2 weeks after operation(P<0.05). The levels of aldosterone (ALD), angiotensin II (Ang II) and norepinephrine(NE) in preoperative intervention group at immediately after operation were lower than those in routine operation group(P<0.05). The scores of SDS and SAS in preoperative intervention group at out of the hospital were lower than those in routine operation group (P<0.05). The scores of VAS and SF-MPQ in preoperative intervention group were lower than those in routine operation group (P<0.05). Conclusion: Preoperative psychological communication and counseling can significantly reduce the stress response of patients undergoing prosthetic knee arthroplasty, improve adverse emotions, reduce postoperative pain, and promote the recovery of patients. |
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