CAJ | 학술논문

目的观察音乐治疗联合舒芬太尼静脉自控镇痛对肺癌手术后患者血液动力学和镇痛效果的影响.方法择期肺癌手术患者60例,按随机数字表法分为二组(n=30):音乐治疗组(M组)和对照组(C组).M组入手术室后,术前接受音乐放松训练15 min,术后3、7、15、19 h分别进行1h音乐干预.C组在同一时间段不听任何音乐.术后M组与C组均接舒芬太尼静脉自控镇痛泵镇痛.观察并记录术后4、8、12、16、20和24h患者收缩压(SBP)、舒张压(DBP)和心率(HR)变化,并记录术后舒芬太尼用量和视觉模拟评分(visual analogue score,VAS)的数值.结果与C组相比,M组患者术后各时点的SBP、DBP、HR和VAS评分值均显著降低(P＜0.01),且M组的术后自控镇痛装置按压次数[C组(30.96±4.00)次,M组(19.06±3.49)次]和舒芬太尼用量[C组(82.65±6.19) μg,M组(52.68±7.07) μg]明显减少(t=12.39,20.00,P＜0.01).结论音乐治疗联合舒芬太尼静脉自控镇痛用于肺癌手术后患者能够产生更好的镇痛效果,且能减少舒芬太尼的用量和更有效降低患者血压和心率,缓解患者的焦虑情绪.
목적 관찰음악치료연합서분태니정맥자공진통대폐암수술후환자혈액동역학화진통효과적영향.방법 택기폐암수술환자60례,안수궤수자표법분위이조(n=30):음악치료조(M조)화대조조(C조).M조입수술실후,술전접수음악방송훈련15 min,술후3、7、15、19 h분별진행1h음악간예.C조재동일시간단불은임하음악.술후M조여C조균접서분태니정맥자공진통빙진통.관찰병기록술후4、8、12、16、20화24h환자수축압(SBP)、서장압(DBP)화심솔(HR)변화,병기록술후서분태니용량화시각모의평분(visual analogue score,VAS)적수치.결과 여C조상비,M조환자술후각시점적SBP、DBP、HR화VAS평분치균현저강저(P＜0.01),차M조적술후자공진통장치안압차수[C조(30.96±4.00)차,M조(19.06±3.49)차]화서분태니용량[C조(82.65±6.19) μg,M조(52.68±7.07) μg]명현감소(t=12.39,20.00,P＜0.01).결론 음악치료연합서분태니정맥자공진통용우폐암수술후환자능구산생경호적진통효과,차능감소서분태니적용량화경유효강저환자혈압화심솔,완해환자적초필정서.
Objective To evaluate musical therapy combined with sufentanil postoperative intravenous analgesia on hemodynamic changes in patient accepted lung cancer operation.Methods Sixty lung cancer surgery patients (ASA Ⅰ-Ⅱ grade) were selected and divided randomly into musical therapy (group M; n =30) and control (group C; n =30).In group M,patients accepted music relaxation training for fifteen minutes before surgery,and music intervention for one hour at 3,7,15,19 hour after surgery.Whereas,in Group C,patients did not listen to any music during the same period.In the intensive care unit,patients were connected to a patient controlled analgesia (PCA) device.The PCA device (sufentanil 2 μg/kg,100 ml saline) was set to deliver a bolus of 2 ml,with a lockout interval of 10 min and background infusion volume of 0.5 ml/h.Hemodynamic changes,the visual analog scale (VAS) and consumption of sufentanil were recorded at the 4th,8th,12th,16th,20th and 24th hour after operation.Results SBP,DBP,HR and VAS of group M were significantly decreased compared to the group C,respectively (P ＜0.05),and significant difference was found in the PCA delivery frequency [group C (30.96 ± 4.00),group M (19.06 ± 3.49),t =12.39,P ＜ 0.01] and postoperative sufentanil consumption[group C (82.65±6.19)μg,group M (52.68 ±7.07)μg,t =20.00,P ＜0.01].Conclusions Musical therapy combined with sufentanil postoperative intravenous analgesia was able to produce better analgesic effect in the treatment of patient accepted lung cancer operation,which decreased postoperative sufentanil consumption and effectively reduced SBP,DBP and HR,and relieved the patient's anxiety.