摘要
目的通过临床应用瑞芬太尼-咪达唑仑辅助麻醉与单纯局部麻醉进行乳腺肿物切除,对比术前术后患者的心理状态变化。方法将400例乳腺肿物切除术患者随机分为镇静组(S组300例)和局麻组(L组100例),S组再随机分为S1组(100例)、S2组(100例)、S3组(100例)。局麻组采用单纯局部麻醉,镇静组应用瑞芬太尼-咪达唑仑辅助麻醉。术前1d、术后3d采用焦虑自评量表SAS、抑郁自评量表SDS、症状自评量表SCL-90对患者进行心理状态测评。结果焦虑自评量表SAS、抑郁自评量表SDS评分显示,局麻组和镇静组术前无差别,镇静组内也无差别(P>0.05)。术后,局麻组和镇静组差别具有统计学意义(P<0.05),局麻组评分明显高于镇静组,镇静组组内差别也具有统计学意义(P<0.05),且S1组的评分高于S2和S3组。症状自评量表SCL-90测评显示,术前镇静组与局麻组在偏执、恐怖、敌对、躯体化等各分量表的得分无差异(P>0.05),术后镇静组的分数明显低于局麻组,差异具有统计学意义(P<0.05),镇静组内的差别有意义(P<0.05),S1组的评分高于S2和S3组。结论在乳腺肿物切除术应用瑞芬太尼—咪达唑仑辅助麻醉的患者比单纯应用局部麻醉的患者术后心理状态较好,适合在临床上推广使用。
Objective To study the psychological characteristics of the mammary lump excision patients. Methods Di- vide 400 patients into L group（ 100 cases）and S group （300 cases）, by random assignment, S group was divided into S1, S2 ,S3 ,every group has 100 cases. L group used the simple anesthesia, S group used assisted anesthesia by remifentanil and midazolam. Psychological assessments： Self - Rating - Anxiety - Scale （ SAS ） , Self - Rating - Depression - Scale （SDS）, Self- reporting Inventory（ SCL- 90）. Results There was no statistically significant difference before operation between S group and L group by SDS, SAS and SCL -90, so was S group （P 〉 0. 05 ）. After operation, there was a statisti- cally significant difference between S group and L group by the score of SDS, SAS and SCL - 90 （ P 〈 0. 05 ） , so was the S group. The score of S1 was higher than S2 and S3. Conclusion Use remifentanil and midazolam assisted anesthesia can improve the psychological characteristics,it is valuable to adopt remifentanil and midazolam in clinical treatment.
出处
《医药论坛杂志》
2013年第8期1-3,共3页
Journal of Medical Forum
基金
2011年廊坊市科学技术研究与发展计划自筹经费项目(2011013019)
