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中华损伤与修复杂志(电子版) ›› 2021, Vol. 16 ›› Issue (06) : 542 -546. doi: 10.3877/cma.j.issn.1673-9450.2021.06.017

护理园地

烧伤患者局部麻醉术前焦虑状况调查及护理干预对策
沈晓娴1, 刘斌1,(), 刘琰2   
  1. 1. 200025 上海交通大学医学院附属瑞金医院护理部
    2. 200025 上海交通大学医学院附属瑞金医院烧伤整形科
  • 收稿日期:2021-09-21 出版日期:2021-12-01
  • 通信作者: 刘斌
  • 基金资助:
    上海市临床重点专科项目(Shslczdzk02302)

Investigation and nursing intervention countermeasures of preoperative anxiety of burn patients under local anesthesia

Xiaoxian Shen1, Bin Liu1,(), Yan Liu2   

  1. 1. Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
    2. Department of Burns and Plastic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Received:2021-09-21 Published:2021-12-01
  • Corresponding author: Bin Liu
引用本文:

沈晓娴, 刘斌, 刘琰. 烧伤患者局部麻醉术前焦虑状况调查及护理干预对策[J]. 中华损伤与修复杂志(电子版), 2021, 16(06): 542-546.

Xiaoxian Shen, Bin Liu, Yan Liu. Investigation and nursing intervention countermeasures of preoperative anxiety of burn patients under local anesthesia[J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2021, 16(06): 542-546.

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、χ2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.

表1 2组烧伤患者一般资料比较
表2 2组烧伤患者的心率与血压水平比较(±s)
表3 2组烧伤患者的焦虑量表评分及信息需要量表得分的比较(分,±s)
表4 2组烧伤患者的疼痛情况比较
[8]
孙继伟,李佳欢,王艳荣,等. 烧伤康复期患者神经质人格、心理弹性与创伤后应激障碍症状和创伤后成长之间的关系[J]. 中国心理卫生杂志2019, 33(3): 198-202.
[10]
牛亚琴,朱侯红,范亚琼. 综合护理干预对重度烧伤患儿照护者的影响[J]. 饮食保健2019, 6(41): 145-146.
[11]
昝望,潘鑫,熊苗苗,等. 术前高度焦虑相关致痛因子的变化及其对术后疼痛的影响[J]. 临床麻醉学杂志2018, 34(8): 768-772.
[12]
Kary AL, Gomez J, Raffaelli SD, et al. Preclinical Local Anesthesia Education in Dental Schools: A Systematic Review[J]. J Dent Educ, 2018, 82(10): 1059-1064.
[13]
潘鑫,昝望,熊苗苗,等. 手术前中重度焦虑发生的相关危险因素[J]. 临床麻醉学杂志2018, 34(5): 425-428.
[14]
曹海茹,孙琦,洪霞,等. 基于合理情绪疗法的心理行为干预降低局麻手术患儿围术期焦虑[J]. 中华整形外科杂志2017, 33(1): 60-62.
[15]
朱飘飘,谭惠仪. 同伴支持在烧伤患者康复中的应用进展[J]. 中华护理杂志2019, 54(9): 1410-1414.
[16]
王雪. 中老年烧伤患者心理健康现况及影响因素[J]. 中国老年学杂志2016, 36(17): 4342-4344.
[17]
高阳. 激励式护理对局麻患者手术期间心境状态及自我评估的影响[J]. 中国医科大学学报2016, 45(8): 758-761.
[18]
岳丽青,王晓燕,彭欢,等. 康复路径对深度烧伤手术后康复效果的影响[J]. 中国现代医学杂志2016, 26(7): 126-132.
[19]
喻春红,王霞. 烧伤严重程度与应对行为及社会支持对中重度烧伤患者早期焦虑与抑郁的影响[J]. 中华烧伤杂志2016, 32(2): 109-111.
[1]
马丽杰,迟艳飞. 医护患一体化健康教育对烧伤患者心理韧性及创伤后成长的影响[J]. 中国健康教育2019, 35(9): 860-863.
[2]
曹庆,王颖,朱毅. 关于加速康复外科理念在日间手术应用的探讨[J]. 中国康复医学杂2020, 35(7): 876-880.
[3]
袁颖,刘瑛,刘彦林,等. 创伤性截肢术后患者疾病感知及影响因素调查分析[J]. 护理学杂志2020, 35(3): 27-30.
[4]
李慧姣,史静华. 日间手术病人术前焦虑的影响因素及护理研究进展[J]. 护理研究2019, 33(24): 4257-4260.
[5]
Chia CT, Theodorou SJ, Dayan E, et al. "Brazilian Butt Lift" under Local Anesthesia: A Novel Technique Addressing Safety Concerns[J]. Plast Reconstr Surg, 2018, 142(6): 1468-1475.Chakhov AA, Ushnitsky ID, Dyachkovskaya TK, et al.Clinical characteristic of factors and tools influencing the effectiveness and safety of local anesthesia in dentistry[J]. Stomatologiia(Mosk), 2018, 97(4): 77-81.
[6]
余云红,赵体玉,夏述燕,等. 手术患儿术前焦虑非药物干预研究进展[J]. 护理学杂志2019, 34(17): 110-112.
[7]
胡燕华,周会兰,梁杨,等. 日间手术患者焦虑情绪管理研究现状[J]. 中国护理管理2019, 19(7): 1054-1057.
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