心理干预对老年患者围术期血流动力学及苏醒质量的影响.doc

心理干预对老年患者围术期血流动力学及苏醒质量的影响 韩旭 解放军第309医院手术室 (北京 100091) 【摘要】 目的：探讨心理干预对老年患者围术期血流动力学及苏醒质量的影响。方法：50例择期行膝关节置换术的老年患者(ASA,Ⅰ-Ⅱ级)随机分为心理干预组(A组, n=25)和对照组(B组, n=25)。两组患者均接受常规围术期护理，A组患者在此基础上实施围术期心理干预。监测并记录两组患者在麻醉前(T1)、插管时(T2)、拔管时(T3)及术后30min(T4)的心率(HR) 、平均动脉压（MAP）的变化及两组患者术毕至完全清醒时各项指标的时间、不良反应的发生率。结果：两组患者在T2、T3、T4与T1比较, HR和MAP均升高，两组患者在T1、T4时，组间比较有显著差异(P﹤0.05)；两组患者术毕至完全清醒时的各项指标，组间相比有显著性差异(P﹤0.05)。两组患者术后不良反应发生率，A组患者明显低于B组患者(P﹤0.05)。结论：心理干预能够保证围术期血流动力学的稳定，缩短拔管的时间，降低术后不良反应的发生率。 【关键词】 心理干预 老年患者 血流动力学 苏醒质量 The effects of psychological intervention on hemodynamics and the quality of awaking in elderly patients during perioperative Han-xu Operating Room, 309th hospital of PLA (Beijing 100091) [Abstract] Objective:To discussion the psychological intervention on hemodynamics and the quality of awaking in elderly patients during perioperative. Methods: 50 patients with Knee Replacement (ASA,Ⅰ-Ⅱ) were randomly divided into two groups: psychological intervention group (group A, n = 25) and control group (group B, n = 25). The two group patients were accepted the same conventional care , based on this, group A patients also accepted the perioperative psychological intervention. Monitoring and recording the changes of two group patients HR, MAP before induction of anesthesia(T1), intubation(T2), extubation(T3) and 30 min after operation(T4), each index′s time after operation to awake and the incidence of adverse reaction were also assessed. Results: The MAP and HR in two group patients in T2, T3, T4 compared with T1 rose obviously, there were exist significant difference between two groups in T1 and T4 (P﹤0.05). Compared with group B, each index′s time after operation to awake and the incidence of adverse reaction were obviously lower in groupA (P﹤0.05). Conclusion: The study suggests that psychological intervention can ensure the stability of hemodynamic, shorten the time of extubation significantly and reduce the incidence of adverse reaction. [Key words] Psychol