摘要
目的探讨围术期护理干预对肱骨近端骨折患者心理状态及应激因子的影响。方法选取2015年8月~2017年1月冀中能源峰峰集团有限公司总医院收治的接受微创手术治疗肱骨近端骨折的患者86例,采用随机数字表法分为观察组和对照组,每组各43例,对照组给予常规护理,对照组在常规护理基础上给予围术期护理干预。采用抑郁自评量表(SDS)、焦虑自评量表(SAS)对入院时、术前及术后患者的心理状态进行评价,对术前、术后促肾上腺皮质激素(ACTH)、皮质醇(COR)、C反应蛋白(CRP)、白细胞(WBC)以及白细胞介素6(IL-6)等应激因子水平进行测定,采用视觉模拟评分法对术后患者的疼痛程度进行评估,采用自制的调查问卷对患者的护理满意度进行评价。结果术前两组患者SDS、SAS评分均高于入院时,术后上述指标均低于入院时和术前,且观察组上述指标变化更加显著,差异均有统计学意义(P<0.05)。术后两组患者ACTH、COR、CRP、WBC、IL-6水平均高于术前,观察组患者上述指标均低于对照组,差异均有统计学意义(均P<0.05)。观察组患者术后疼痛评分明显低于对照组,护理满意度高于对照组,差异均有统计学意义(均P<0.05)。结论围术期护理干预能够减少肱骨近端骨折患者的负性情绪及疼痛体验,有效减轻机体的炎性反应,提高患者舒适度,值得临床推广应用。
Objective To investigate the influences of perioperative nursing intervention on psychological status and stress factors in patients with proximal humeral fracture. Methods Eighty six patients with proximal humerus fracture treated with minimally invasive surgery from August 2015 to January 2017 in General Hospital of Jizhong Energy Fengfeng Group were selected and divided into the control group and the observation group by digital number table, with 43 cases in each group. The control group was given routine nursing care and the observation group was given perioperative nursing intervention on the basis of routine nursing care. Self-rating depression scale （SDS） and self-rating anxiety scale （SAS） were used to evaluate the psychological status of the patients on admission time, before and after surgery. The levels of stress factors such as adrenocorticotrophic hormone （ACTH）, cortisol （COR）, C-reactive protein （CRP）, white blood cell （WBC） and interleukin-6 in the two groups were measured preoperative and postoperative. The postoperative pain was evaluated by visual analogue scale （VAS） and nursing satisfaction was evaluated by self-designed questionnare. Results Before operation, the scores of SDS and SAS in the two groups were all higher than admission. After operation, the scores above were all lower than admission and preoperative, and the observation group decreased more remarkably, with statistically significant difference （P 〈 0.05）. After operation, the level of ACTH, COR, CRP, WBC and IL-6 were all higher than those of before operation, and the indexes above in the observation group were significantly lower than those of control group, with statistically significant difference （all P 〈 0.05）. The score of VAS in the observation group was lower than that of control group, and the nursing satisfaction was higher than that of the control group, with statisti- cally significant differences （all P 〈 0.05）. Conclusion The perioperative nursing intervention can red
出处
《中国医药导报》
CAS
2017年第31期169-172,共4页
China Medical Herald
基金
河北省邯郸市科学技术研究与发展计划项目(1623208100ZC)
关键词
肱骨近端骨折
围术期护理
心理状态
应激因子
Proximal humeral fracture
Perioperative care
Psychological status
Stress factor
