CAJ | 학술논문

目的：探讨联合心理干预对老年患者美容手术应激反应的影响。方法60例老年美容手术患者随机分为对照组和联合心理干预组，每组各30例，对照组采用常规的术前访视及术中常规护理，干预组在对照组的基础上给予联合心理干预（包括心理干预、情绪干预、行为干预和音乐放松干预）。记录入院时、手术前和术后焦虑自评量表（ SAS）、抑郁自评量表（ SDS）及术后疼痛视觉模拟评分评分（ VAS）指标的变化；观察患者入院时、手术前、手术即刻和术后的平均动脉压（ MAP）、心率（ HR）变化；测定患者相应不同时期的血清肾上腺素（ E）及去甲肾上腺素（ NE）浓度。结果联合心理干预组和对照组入院时的SAS/SDS值、HR、MAP及血清NE和E浓度无显著差异（ P >0.05）；联合心理干预组患者术前SAS/SDS评分、HR、MAP及血清NE和E浓度低于对照组和入院时（ P <0.05）；干预组术后VAS评分低于对照组（ P <0.05）。结论联合心理干预能有效减轻老年美容手术患者术前焦虑、抑郁程度，降低手术麻醉应激反应，稳定循环系统，减轻术后疼痛程度，从而提高患者对手术的耐受性，保证麻醉和手术的顺利实施。
목적：탐토연합심리간예대노년환자미용수술응격반응적영향。방법60례노년미용수술환자수궤분위대조조화연합심리간예조，매조각30례，대조조채용상규적술전방시급술중상규호리，간예조재대조조적기출상급여연합심리간예（포괄심리간예、정서간예、행위간예화음악방송간예）。기록입원시、수술전화술후초필자평량표（ SAS）、억욱자평량표（ SDS）급술후동통시각모의평분평분（ VAS）지표적변화；관찰환자입원시、수술전、수술즉각화술후적평균동맥압（ MAP）、심솔（ HR）변화；측정환자상응불동시기적혈청신상선소（ E）급거갑신상선소（ NE）농도。결과연합심리간예조화대조조입원시적SAS/SDS치、HR、MAP급혈청NE화E농도무현저차이（ P >0.05）；연합심리간예조환자술전SAS/SDS평분、HR、MAP급혈청NE화E농도저우대조조화입원시（ P <0.05）；간예조술후VAS평분저우대조조（ P <0.05）。결론연합심리간예능유효감경노년미용수술환자술전초필、억욱정도，강저수술마취응격반응，은정순배계통，감경술후동통정도，종이제고환자대수술적내수성，보증마취화수술적순리실시。
Objective Toexploretheeffectivenessofcomprehensivepsychologicalinterventiononstressresponseinsenilepatientsunder-goingcosmeticsurgery.Methods Sixtysenilefemalepatientswererandomlydividedintocontrolgroup(groupC)andinterventiongroup(group I),each with 30 cases. Patients in group C were given with routine pre-operative visit and conventional intra-operative nursing care. Patients in group I received comprehensive psychological intervention as well as routine visit and nursing care,including psychological intervention,mental mood intervention,behavior intervention and music relaxing intervention. Zung self-rating anxiety scale( SAS)and self-rating depression scale ( SDS〗were recorded at admission,before and after operation. Mean artery pressure( MAP)and heart rate( HR)were recorded at admission,be-fore operation,at the beginning and after operation. Serum levels of epinephrine(E)and nor-epinephrine(NE)were measured in patients of bothgroupsatcoincidenttimepoints.Results SAS/SDS,MAP,HRandserumlevelsofNEandEingroupIbeforesurgeryweresignificantly lowerthanthoseingroupCandthoseatadmission.Conclusion Comprehensivepsychologicalinterventioncanwellrelieveanxiety,lowerdepres-sion and phobic emotion and reduce stress response in senile patients undergoing cosmetic surgery,thus it may promote physical and mental health of patients before operation.