摘要
目的研究烧伤患者局部麻醉术前焦虑状况及护理干预对策,为临床局部麻醉患者的术前护理提供依据。方法选择2019年1月至2020年9月在上海交通大学医学院附属瑞金医院烧伤整形科接受治疗并给予针对性护理的90例烧伤患者作为本次的研究组;选择2018年1月至2018年12月在上海交通大学医学院附属瑞金医院烧伤整形科给予常规性护理的90例患者作为对照组。对照组给予常规护理。研究组在对照组患者处理的基础上给予有针对性的护理,包括进行简易有效的心理评估,主动向患者沟通、宣教手术方式,运用音乐疗法放松患者紧张情绪,并请家属协同支持等。比较2组患者的心率、舒张压与收缩压水平,护理前后阿姆斯特丹术前焦虑量表(APAIS)评分(包括焦虑量表得分与信息需要量表得分)、疼痛情况。数据行t检验、χ^(2)检验。结果护理前,研究组与对照组患者心率、收缩压、舒张压比较,差异均无统计学意义(P=0.684、0.790、0.672);护理后,研究组患者心率、收缩压、舒张压分别为(73.82±6.21)次/min、(112.59±3.21)mmHg(1 mmHg=0.133 kPa)、(68.72±5.15)mmHg,明显低于对照组患者[(80.60±6.63)次/min、(131.82±4.05)mmHg、(82.48±7.43)mmHg],差异均有统计学意义(t=7.081、35.301、14.440,P=0.009、0.012、0.014)。护理前,研究组患者的焦虑量表得分、信息需要量表得分分别与对照组比较,差异均无统计学意义(P=0.782、0.696);护理后,研究组患者的焦虑量表得分与信息需要量表得分为(8.71±2.19)、(13.54±3.37)分,均明显低于对照组患者[(3.71±0.45)、(4.53±0.82)分],差异均有统计学意义(t=11.401、8.317,P<0.05)。研究组患者的总疼痛率为22例(24.44%),明显低于对照组患者[38例(42.22%)],差异有统计学意义(t=4.091,P=0.043)。结论烧伤患者局部麻醉术前会出现不同程度的焦虑情绪,通过心理评估、认知疗法、放松疗法、社会支持的护理对策能够有效改善患者的不良情绪,值得临床推广应用。
Objective To study the anxiety status and nursing intervention countermeasures of burn patients before local anesthesia,in order to provide basis for preoperative nursing of patients under clinical local anesthesia.Method Ninty burn patients treated in the Department of Burns and Plastic Surgery,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine from January 2019 to September 2020 were selected as the study group,they were given targeted nursing care.Ninty patients in the Department of Burns and Plastic Surgery,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine from January 2018 to December 2018 were selected as the control group,they were given coventional nursing.The control group was given routine preoperative nursing.On the basis of the treatment of patients in the control group,the study group was given targeted nursing,including simple and effective psychological evaluation,active communication with patients,teaching operation methods,using music therapy to relieve patients′tension,and inviting family members to cooperate and support.The levels of heart rate,diastolic blood pressure and systolic blood pressure,amsterdam preoperative anxiety scale score(anxiety subscale and information needs subscale)and pain were compared between the two groups.Data were processed with t test and chi-square test.Results Before nursing,there were no significant differences in heart rate,systolic blood pressure and diastolic blood pressure between the study group and the control group(P=0.684,0.790,0.672).After nursing,the heart rate,systolic blood pressure and diastolic blood pressure in the study group were(73.82±6.21)times/min,(112.59±3.21)mmHg(1 mmHg=0.133kPa)and(68.72±5.15)mmHg,which were significantly lower than those in the control group[(80.60±6.63)times/min,(131.82±4.05)mmHg and(82.48±7.43)mmHg,the differences were statistically significant(t=7.081,35.301,14.440;P=0.009,0.012,0.014).Before nursing,there were no significant difference between the control and study group(P=0.782,0.696).After nursing,the scores of anxiety scale and information needs scale in the study group were(8.71±2.19),(13.54±3.37)points,which were significantly lower than those in the control group[(3.71±0.45),(4.53±0.82)points],the difference were statistically significant(t=11.401,8.317;P<0.05).The total pain rate in the study group was 22 patients(24.44%),which was significantly lower than that in the control group[38 patients(42.22%)],the difference was statistically significant(t=4.091,P=0.043).Conclusion Local anesthesia surgery patients will have different degrees of anxiety before surgery,through psychological assessment,cognitive therapy,relaxation therapy,social support nursing countermeasures can effectively improve the patient's bad mood,worthy of clinical application.
作者
沈晓娴
刘斌
刘琰
Shen Xiaoxian;Liu Bin;Liu Yan(Department of Nursing,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Department of Burns and Plastic Surgery,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)
出处
《中华损伤与修复杂志（电子版）》
CAS
2021年第6期542-546,共5页
Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)
基金
上海市临床重点专科项目(Shslczdzk02302)。
关键词
烧伤
麻醉
局部
焦虑
护理
疼痛
Burns
Anesthesia,local
Anxiety
Nursing care
Pain
