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心理干預(yù)聯(lián)合患者自控鎮(zhèn)靜術(shù)對手術(shù)期間疼痛的影響
（作者未知） 2010/8/30
[摘要] 目的:研究圍術(shù)期藥物-心理綜合鎮(zhèn)痛法對疼痛、應(yīng)激的影響。方法:60例ASAⅠ級擇期頜面部手術(shù)患者,隨機(jī)分為兩組,Ⅰ組常規(guī)圍術(shù)期準(zhǔn)備;Ⅱ組心理干預(yù)和患者自控鎮(zhèn)靜(PCS)。監(jiān)測患者術(shù)前,術(shù)中10、30、60 min,術(shù)后24 h的HR,MAP,SpO2,術(shù)中采用警覺/鎮(zhèn)靜(OAA/S)評分。于術(shù)前、術(shù)中1 h、術(shù)后24 h取外周靜脈血,用放射免疫分析法測定血清中的SP、β-EP及皮質(zhì)醇含量,術(shù)后24 h應(yīng)用視覺模擬評分(VAS)評定術(shù)后疼痛。結(jié)果:患者一般資料比較,差異無統(tǒng)計(jì)學(xué)意義(P﹥0.05)。心率,MAP術(shù)中30、60 minⅠ組較Ⅱ組明顯升高(P﹤0.05);SpO2在術(shù)中60 minⅡ組較Ⅰ組降低(P﹤0.05);SP、皮質(zhì)醇術(shù)中1 h、術(shù)后24 h Ⅰ組較Ⅱ組升高明顯(P﹤0.01);β-EP術(shù)中1 hⅠ組較Ⅱ組明顯降低(P﹤0.05);OAA/S評分兩組在術(shù)中呈現(xiàn)先低后高(P﹤0.05);Ⅱ組疼痛不適的程度明顯低于Ⅰ組。結(jié)論:心理干預(yù)聯(lián)合PCS明顯減輕應(yīng)激反應(yīng);增強(qiáng)患者對手術(shù)疼痛的耐受,進(jìn)一步完善鎮(zhèn)痛效果,促進(jìn)術(shù)后康復(fù)。
[關(guān)鍵詞] 心理干預(yù);患者自控鎮(zhèn)靜;鎮(zhèn)痛;手術(shù)
[Abstract] Objective: Study of perioperative medicine-psychological analgesia method integrated pain, stress effects. Methods: ASA Ⅰ 60 cases of elective maxillofacial surgery were randomly divided into two groups,Ⅰ Group were given general perioperative preparation;Ⅱ group were given psychological intervention and patient-controlled sedation (PCS). Monitoring of preoperative,intraoperative 10,30,60 min,after 24 hours of HR, MAP, SpO2, intraoperative use of OAA/S sedation score. In the preoperative,intraoperative 1 hour, 24 hours after peripheral venous blood taken,measured with radioimmunoassay in serum of SP,β-EP and cortisol levels 24 hours after application of VAS assessment of pain. Results: General information of patients,the difference was not significant (P﹥0.05). Heart rate,MAP surgery 30,60 min Ⅰgroup were significantly higher than group Ⅱ (P﹤0.05); SpO2 during surgery 60 min Ⅱ group than in group Ⅰ lower (P﹤0.05); SP, intraoperative cortisol 1 hour, after 24 hoursⅠ group significantly higher than that in group Ⅱ (P﹤0.01); β-EP surgery group than in the 1 hour Ⅰgroup was significantly lower than group Ⅱ (P﹤0.05); OAA/S score two in the surgery at first and after the high-low (P﹤0.05);Ⅱ group was significantly lower than the degree of pain and discomfort in group Ⅰ. Conclusion: PCS psychological intervention can significantly reduces joint stress;increases pain tolerance to surgical patients,to further improve the analgesic effect,and promote post（未完，下一頁）
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