CAJ | 학술논문

目的探讨PCI术前干预对患者术时应激反应行为及结局的影响.方法选择2010年11月至2011年9月符合纳入标准的心血管患者106例,按随机数字法随机分为观察组和对照组,每组53例.对照组只进行常规术前检查和健康教育,观察组除了接受常规术前检查和术前健康教育外,还在术前20 min接受由专业按摩人员给予的统一的、标准化的肩背部按摩护理.比较两组患者的收缩压、舒张压、脉率等生理应激反应指标,同时使用自评视觉量尺(VAS)和状态-特质焦虑量表(STAI)分析两组患者的焦虑、紧张程度和患者自述术中疼痛程度作为心理应激反应指标.结果干预前两组患者的生理应激反应指标和心理应激反应指标得分差异无统计学意义(P＞0.05)；干预后观察组患者舒张压(77.82±12.23)mm Hg,心率(70.55±4.88)次/min,进手术间心率(76.41±11.06)次/min,S-AI评分(35.71±9.55)分,T-AI评分(37.08±9.45)分,VAS得分(1.94±1.03)分,均低于对照组(88.13±11.06)mm Hg,(74.75±5.98)次/min,(84.96±19.53)次/min,(44.84±7.41)分,(42.31±8.52)分,(3.87±1.55)分,两组比较差异均有统计学意义(t分别为4.552,3.962,2.773,5.499,2.992,7.550；P均＜0.05).干预后观察组收缩压(128.74±14.64) mm Hg,与对照组(124.45±17.32)mmHg比较差异无统计学意义(t=1.377,P＞0.05).结论术前按摩护理干预支持可有效减轻心血管介入患者的焦虑、紧张和疼痛程度,在一定程度上改善患者术后结局,从而进一步支持按摩护理的效用,增强患者面对PCI术的信心和勇气.
목적 탐토PCI술전간예대환자술시응격반응행위급결국적영향.방법 선택2010년11월지2011년9월부합납입표준적심혈관환자106례,안수궤수자법수궤분위관찰조화대조조,매조53례.대조조지진행상규술전검사화건강교육,관찰조제료접수상규술전검사화술전건강교육외,환재술전20 min접수유전업안마인원급여적통일적、표준화적견배부안마호리.비교량조환자적수축압、서장압、맥솔등생리응격반응지표,동시사용자평시각량척(VAS)화상태-특질초필량표(STAI)분석량조환자적초필、긴장정도화환자자술술중동통정도작위심리응격반응지표.결과 간예전량조환자적생리응격반응지표화심리응격반응지표득분차이무통계학의의(P＞0.05)；간예후관찰조환자서장압(77.82±12.23)mm Hg,심솔(70.55±4.88)차/min,진수술간심솔(76.41±11.06)차/min,S-AI평분(35.71±9.55)분,T-AI평분(37.08±9.45)분,VAS득분(1.94±1.03)분,균저우대조조(88.13±11.06)mm Hg,(74.75±5.98)차/min,(84.96±19.53)차/min,(44.84±7.41)분,(42.31±8.52)분,(3.87±1.55)분,량조비교차이균유통계학의의(t분별위4.552,3.962,2.773,5.499,2.992,7.550；P균＜0.05).간예후관찰조수축압(128.74±14.64) mm Hg,여대조조(124.45±17.32)mmHg비교차이무통계학의의(t=1.377,P＞0.05).결론 술전안마호리간예지지가유효감경심혈관개입환자적초필、긴장화동통정도,재일정정도상개선환자술후결국,종이진일보지지안마호리적효용,증강환자면대PCI술적신심화용기.
Objective To explore the effect of nursing intervention for the patients awaiting the PCI surgery on the patients' stress response and outcomes.Methods One hundred and six patients who underwent the PCI surgery and met the inclusion criteria between November 2010 and September 2011 were recruited and randomly divided into control group and experiment group,with 53 patients in each group.The patients in the control group received routine preoperative examinations.In addition,the patients in the experiment group received a unified and standardized massage care provided by the therapists.Shoulders and back were the areas massaged.Pulse rate,systolic and diastolic blood pressure were compared as a physiological stress,the pain,anxiety and VAS scores were compared between two groups.Results Before the intervention,there was no significant differences in the scores of the physiological and psychological stress ( P ＞ 0.05 ).After the intervention,the scores of the diastolic blood pressure(77.82 ± 12.23)mm Hg,heart rate(70.55 ±4.88)times/min,heart rate of going into surgery room(76.41 ± 11.(06) times/min,S-AI(35.71 ±9.55),T-AI (37.08 ±9.45),VAS(1.94±1.03) of the experiment group were lower than those of the control group(88.13 ± 11.06)mm Hg,(74.75 ± 5.98 ),( 84.96 ± 19.53 ) times/min,( 44.84 ± 7.41 ),( 42.31 ± 8.52 ),( 3.87 ± 1.55 ),and the differences were statistically significant( P ＜0.05 ).There were no significant differences in the systolic blood pressure between the experiment group( 128.74 ± 14.64 ) mm Hg and control group ( 124.45 ± 17.32 ) mm Hg (t =1.377,P ＞0.05 ).Conclusions The preoperative massage nursing intervention and support can effectively improve the anxiety,intense and pain of the patients during surgery and improve postoperative outcomes to some extent,promote the utility of massage care and increase patients' confidence and courage to face the PCI surgery.