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目的:探讨不同干预方法对肺癌患者围术期血流动力学的影响。方法:将60例行肺叶切除术肺癌患者随机分为A组、B组、C组、D组各15例,A组为对照组行常规护理,术后根据需要间断肌内注射哌替啶镇痛;B组行常规护理+音乐放松想象训练(MRIT),术后根据需要间断肌内注射哌替啶镇痛;C组行常规护理+术后患者静脉自控镇痛(PCIA);D组行常规护理+MRIT+术后PCIA。监测术前30 min、术毕及术后24 h、48 h、5 d各组BP、HR及VAS评分情况。结果:四组不同时段收缩压、舒张压、HR值及VAS评分比较,干预主效应有统计学意义(P<0.05,P<0.01),以D组最优。结论:围术期实行MRIT联合PCIA能提供完善的镇痛效果,维持血流动力学稳定,效果明显优于单独实施MRIT和PCIA。
Objective: To investigate the effects of different interventions on perioperative hemodynamics in patients with lung cancer. Methods: Sixty patients with lung cancer undergoing lobectomy were randomly divided into A group, B group, C group and D group, with 15 cases in each group. A group was given routine nursing care, and intermittent intramuscular injection of pethidin Group B received routine nursing and music relaxation imaging training (MRIT), postoperative intramuscular injection of pethidine analgesia after operation; Group C routine nursing + postoperative patient controlled intravenous analgesia (PCIA); Group D Routine nursing + MRIT + postoperative PCIA. The levels of BP, HR and VAS in each group were monitored 30 min before operation, 24 h, 48 h and 5 d after operation. Results: The systolic blood pressure, diastolic blood pressure, HR value and VAS score at different time points were significantly different (P <0.05, P <0.01). Conclusion: Perioperative implementation of MRIT combined with PCIA can provide complete analgesic effect, maintain hemodynamic stability, the effect is better than the separate implementation of MRIT and PCIA.