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目的探讨治疗性抚触护理干预对甲状腺手术患者围术期应激反应的影响。方法选取宜丰县人民医院普外科2015年6月—2016年3月收治的择期行甲状腺手术患者90例,随机分为对照组和观察组,各45例。对照组患者在围手术期给予常规护理,观察组患者在对照组基础上给予治疗性抚触护理干预。评估比较两组患者术后2 h、6 h视觉模拟疼痛评分法(VAS)评分,入室前、麻醉时、分离时、术后2 h、术后6 h血流动力学(收缩压、舒张压、心率)及护理前、术后2 d焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分。结果术后2 h、6 h,观察组患者VAS评分低于对照组(P<0.05)。入室前和术后6 h,两组患者收缩压、舒张压、心率比较,差异无统计学意义(P>0.05);麻醉时、分离时、术后2 h,观察组患者收缩压、舒张压和心率低于对照组(P<0.05)。护理前,两组患者SAS评分和SDS评分比较,差异无统计学意义(P>0.05);术后2 d,观察组患者SAS评分、SDS评分低于对照组(P<0.05)。结论治疗性抚触为主的综合护理干预可有效缓解甲状腺手术患者的疼痛程度,降低围术期应激反应。
Objective To investigate the effect of therapeutic nursing intervention on perioperative stress response in thyroid surgery patients. Methods Totally 90 patients undergoing elective thyroidectomy in General Surgery Department of Yifeng People’s Hospital from June 2015 to March 2016 were randomly divided into control group and observation group, with 45 cases in each group. Patients in the control group were given routine nursing care during the perioperative period. Patients in the observation group were given therapeutic nursing intervention on the basis of the control group. The VAS scores at 2 h and 6 h after operation were compared between the two groups before operation, before anesthesia, at the time of separation, 2 h after operation and 6 h after operation. The hemodynamic parameters (systolic pressure, diastolic pressure , Heart rate (HR)) and SAS scores before and 2 days after surgery, SDS score. Results The VAS score of the observation group was lower than that of the control group 2 h and 6 h after operation (P <0.05). The systolic blood pressure, diastolic blood pressure and heart rate in the two groups had no significant difference before and 6 h after operation (P> 0.05). At the time of anesthesia, at 2 h after operation, systolic blood pressure, diastolic blood pressure And heart rate was lower than the control group (P <0.05). Before nursing, there was no significant difference between the two groups in SAS score and SDS score (P> 0.05). On the 2nd postoperative day, SAS score and SDS score in the observation group were lower than those in the control group (P <0.05). Conclusion The comprehensive nursing intervention based on therapeutic touch can effectively relieve the pain of thyroid surgery patients and reduce the perioperative stress response.