上海医学
上海醫學
상해의학
SHANGHAI MEDICAL JOURNAL
2009年
10期
888-891
,共4页
心理干预%咪达唑仑%不孕症%应激反应%皮质醇%促肾上腺皮质激素%血管紧张素Ⅱ
心理榦預%咪達唑崙%不孕癥%應激反應%皮質醇%促腎上腺皮質激素%血管緊張素Ⅱ
심리간예%미체서륜%불잉증%응격반응%피질순%촉신상선피질격소%혈관긴장소Ⅱ
Psychological intervention%Midazolam%Sterility%Stress response%Corticosteroid%Adrenocorticotropic hormone%Angiotensin Ⅱ
目的 探讨综合心理干预联合咪达唑仑对不孕症患者术前心理应激反应的影响.方法 60例不孕症患者随机分为3组,每组20例.Ⅰ组为对照组,进行常规的术前准备.Ⅱ组为心理干预组,在手术准备期间进行2～3次的心理干预.Ⅰ组和Ⅱ组术前均不使用镇静药.Ⅲ组为心理干预联合咪达唑仑组,在手术准备期间进行2～3次的心理干预,进入手术室前30 min肌内注射咪达唑仑0.05 mg/kg.所有患者在入院次日晨(人院时)和进入手术室后(入室时)各抽取静脉血4 mL,检测血清皮质醇(Cor)、促肾上腺皮质激素(ACTH)、血管紧张素-Ⅱ(AT-Ⅱ)和血糖(PG)水平,记录相应时间点患者的心率(HR)、血压(BP)和脉搏血氧饱和度(SpO_2),并进行Zung焦虑量表(SAS)、抑郁量表(SDS)评分.结果 入院时3组间的HR、BP、SpO_2和血清Cor、ACTH、AT-Ⅱ、PG水平以及SAS和SDS评分的差异均无统计学意义(P值均>0.05).入室时,Ⅰ组以上指标均显著升高(P值分别<0.01、0.05);Ⅱ组除SAS、SDS评分显著降低外(P值均<0.05),其他指标的变化均不明显(P值均>0.05);Ⅲ组以上指标均显著降低(P值分别<0.05、0.01).入室时,Ⅱ组和Ⅲ组以上指标均显著低于Ⅰ组(P值分别<0.05、0.01),Ⅲ组又显著低于Ⅱ组(P值分别<0.01、0.05).结论 综合心理干预能有效地改善不孕症患者术前的心理健康状况,降低患者术前心理应激反应的水平,咪达唑仑能强化心理干预的效果.
目的 探討綜閤心理榦預聯閤咪達唑崙對不孕癥患者術前心理應激反應的影響.方法 60例不孕癥患者隨機分為3組,每組20例.Ⅰ組為對照組,進行常規的術前準備.Ⅱ組為心理榦預組,在手術準備期間進行2～3次的心理榦預.Ⅰ組和Ⅱ組術前均不使用鎮靜藥.Ⅲ組為心理榦預聯閤咪達唑崙組,在手術準備期間進行2～3次的心理榦預,進入手術室前30 min肌內註射咪達唑崙0.05 mg/kg.所有患者在入院次日晨(人院時)和進入手術室後(入室時)各抽取靜脈血4 mL,檢測血清皮質醇(Cor)、促腎上腺皮質激素(ACTH)、血管緊張素-Ⅱ(AT-Ⅱ)和血糖(PG)水平,記錄相應時間點患者的心率(HR)、血壓(BP)和脈搏血氧飽和度(SpO_2),併進行Zung焦慮量錶(SAS)、抑鬱量錶(SDS)評分.結果 入院時3組間的HR、BP、SpO_2和血清Cor、ACTH、AT-Ⅱ、PG水平以及SAS和SDS評分的差異均無統計學意義(P值均>0.05).入室時,Ⅰ組以上指標均顯著升高(P值分彆<0.01、0.05);Ⅱ組除SAS、SDS評分顯著降低外(P值均<0.05),其他指標的變化均不明顯(P值均>0.05);Ⅲ組以上指標均顯著降低(P值分彆<0.05、0.01).入室時,Ⅱ組和Ⅲ組以上指標均顯著低于Ⅰ組(P值分彆<0.05、0.01),Ⅲ組又顯著低于Ⅱ組(P值分彆<0.01、0.05).結論 綜閤心理榦預能有效地改善不孕癥患者術前的心理健康狀況,降低患者術前心理應激反應的水平,咪達唑崙能彊化心理榦預的效果.
목적 탐토종합심리간예연합미체서륜대불잉증환자술전심리응격반응적영향.방법 60례불잉증환자수궤분위3조,매조20례.Ⅰ조위대조조,진행상규적술전준비.Ⅱ조위심리간예조,재수술준비기간진행2～3차적심리간예.Ⅰ조화Ⅱ조술전균불사용진정약.Ⅲ조위심리간예연합미체서륜조,재수술준비기간진행2～3차적심리간예,진입수술실전30 min기내주사미체서륜0.05 mg/kg.소유환자재입원차일신(인원시)화진입수술실후(입실시)각추취정맥혈4 mL,검측혈청피질순(Cor)、촉신상선피질격소(ACTH)、혈관긴장소-Ⅱ(AT-Ⅱ)화혈당(PG)수평,기록상응시간점환자적심솔(HR)、혈압(BP)화맥박혈양포화도(SpO_2),병진행Zung초필량표(SAS)、억욱량표(SDS)평분.결과 입원시3조간적HR、BP、SpO_2화혈청Cor、ACTH、AT-Ⅱ、PG수평이급SAS화SDS평분적차이균무통계학의의(P치균>0.05).입실시,Ⅰ조이상지표균현저승고(P치분별<0.01、0.05);Ⅱ조제SAS、SDS평분현저강저외(P치균<0.05),기타지표적변화균불명현(P치균>0.05);Ⅲ조이상지표균현저강저(P치분별<0.05、0.01).입실시,Ⅱ조화Ⅲ조이상지표균현저저우Ⅰ조(P치분별<0.05、0.01),Ⅲ조우현저저우Ⅱ조(P치분별<0.01、0.05).결론 종합심리간예능유효지개선불잉증환자술전적심리건강상황,강저환자술전심리응격반응적수평,미체서륜능강화심리간예적효과.
Objective To investigate the effect of comprehensive psychological intervention combined with midazolam on the preoperative stress response in sterile females. Methods Sixty sterile women were randomly divided into three groups, each with 20 cases. Group Ⅰ (control group): routine preoperativepreparations, group Ⅱ (psychological intervention group): receiving 2-3 times psychological interventions during preparation of operation. Group Ⅰ and group Ⅱ received no preoperative sedative. Group Ⅲ (psychological intervention combined with midazolam group) : receiving 2-3 times psychological interventions during preparation of operation, and receiving muscular injection of midazolam (0.05 mg/kg) 30 min before entering operation room. Blood samples (4 mL) were taken in the next morning after admission and after entering the operation room. The serum concentrations of corticosteroid (Cor), adrenocorticotropic hormone (ACTH), angiotensin Ⅱ (AT-Ⅱ), plasma glucose (PG) and recorded with heart rate (HR), blood pressure (BP), oxygen saturation (SpO_2), Zung anxiety grade and depression grade (SAS, SDS) scores were all examined. Results There were no significant differences in HR, BP, serum concentrations of Cor, ACTH, AT-Ⅱ , PG, and SAS, SDS scores between the three groups at the admission (all P>0.05). After entering operation room, the above data in group Ⅰ were significantly increased (P<0.01 or 0.05) ; no other changes (all P>0.05) except that significantly lower SAS, SDS scores were found in group Ⅱ (all P<0.05); and all the data in group Ⅲ were significantly decreased (P<0.01 or 0.05). Compared with group Ⅰ , the item levels of group Ⅱ and Ⅲ were significantly decreased (P<0.01 or 0.05), and also those of the group Ⅲ were significantly lower than those of group Ⅱ (P<0.01 or 0.05).Conclusion Comprehensive psychological intervention can effectively improve the psychological health of sterile patients, lover the preoperative stress response level; besides, midazolam can enhance the effect of psychological intervention.
