CAJ | 학술논문

目的用症状自评量表(symptom check list 90,SCL-90)、警觉/镇静评分(observers assessment of alertness/sedation scale,OAA/S)评价拇手指再造术患者围术期进行心理干预、术中靶控镇静治疗对术后疼痛和一般心理状态的影响.方法选择拟在臂丛神经阻滞+腰硬联合麻醉下行足趾移植再造拇、手指术患者80例,随机数字表法分成4组,每组20例.A组围术期心理干预+术中咪唑安定靶控镇静治疗;B组常规处置;C组围术期心理干预;D组术中咪唑安定靶控镇静治疗.观察并记录生命体征、OAA/S评分、视觉模拟评分(VAS)及SCL-90评分.结果 A、D组术中OAA/S评分较B、C组稳定(P＜0.05);A组术后VAS评分和SCL-90心理状态评估明显优于B、C、D组(P＜0.05).结论围术期心理干预、术中咪唑安定靶控镇静可减轻拇手指再造患者术后疼痛,减轻围术期强迫症状、抑郁及焦虑状态,改善饮食睡眠状况,提高术后康复质量.
목적 용증상자평량표(symptom check list 90,SCL-90)、경각/진정평분(observers assessment of alertness/sedation scale,OAA/S)평개무수지재조술환자위술기진행심리간예、술중파공진정치료대술후동통화일반심리상태적영향.방법 선택의재비총신경조체+요경연합마취하행족지이식재조무、수지술환자80례,수궤수자표법분성4조,매조20례.A조위술기심리간예+술중미서안정파공진정치료;B조상규처치;C조위술기심리간예;D조술중미서안정파공진정치료.관찰병기록생명체정、OAA/S평분、시각모의평분(VAS)급SCL-90평분.결과 A、D조술중OAA/S평분교B、C조은정(P＜0.05);A조술후VAS평분화SCL-90심리상태평고명현우우B、C、D조(P＜0.05).결론 위술기심리간예、술중미서안정파공진정가감경무수지재조환자술후동통,감경위술기강박증상、억욱급초필상태,개선음식수면상황,제고술후강복질량.
Objective To evaluate the clinic effects of perioperative psychological intervention combined appropriate sedation by target-controlled infusion of midazolam during operation via symptom check List 90 (SCL-90) and observers assessment of alertness/sedation scale (OAA/S) in patients undergoing thumb or finger reconstruction.Methods Eighty patients undergoing thumb or finger reconstruction were randomly divided into group A,B,C,and D (n =20 cases per group).All patients were received brachial plexus block and spinal-epidural combined anesthesia.Patients in group A were given perioperative psychological intervention combined appropriate sedation by target-controlled infusion of midazolam during operation; patients in group B were received routine treatment; patients in group C were given perioperative psychological intervention; and patients in group D were sedated with midazolam during operation.The vital signs and the scores of OAA/S were observed during operation.The scores of visual analogue scale (VAS) and SCL-90 were recorded after operation.Results The OAA/S grade in groups A and D were stability than that in groups B and C (P ＜ 0.05) ; the scores of VAS and the results of psychological status assessment by SCL-90 in group A were superior to groups B,C,and D (P ＜ 0.05).Conclusions Perioperative psychological intervention combined appropriate sedation in operation on thumb or finger reconstruction is a excellence anaesthesia processing method.It might have beneficial effects on postoperative recovery profile,and strengthen the tolerance to pain and improve the patient's psychological status during operative period.