心理干预在学龄儿童围手术期的应用
发布时间：2019-01-27 21:32
【摘要】： 儿童对手术麻醉极为恐惧、紧张和焦虑;这往往会引起麻醉前和围手术期应激反应增强,严重者可发生意外。儿童因其身心发育不成熟,在围手术期会经历从心理到生理的一系列应激反应,不仅影响麻醉诱导和手术的平顺,还会造成儿童术中、术后不同程度的心理和行为异常。手术作为一种主要的疾病治疗手段,一方面能给病人解除疾病的痛苦,挽救生命;另一方面,手术对患者来说是一种强烈的刺激源,可使患者产生较强的生理与心理反应。特别是对儿童而言,他们的心理承受力较弱,较强的心理刺激如不及时疏导,会给他们带来心理伤害,有的甚至留下心理阴影,影响以后的学习和生活。积极主动对患儿和家属进行心理干预,可缩短彼此的距离,消除顾虑,减少陌生感,增加信任,便于相互沟通,更利于减轻患儿对手术的恐惧感。因此,儿童手术前后的心理干预对保证手术安全,加快患儿身体恢复有重要意义。 本文选择45例择期手术的7-14岁住院儿童(无心理、精神障碍和高血压、内分泌系统疾病及其他危重手术等)对其进行心理干预;用以探讨心理干预在学龄儿童围术期应用的临床价值,以及麻醉手术过程患儿的心理活动和这些心理活动对儿童适应麻醉的能力及其对身心及神经-内分泌系统的影响以及给予心理干预后产生的临床效果。结果表明接受心理干预实验组患儿入室后安静,能配合术前准备、外周静脉穿刺、采血及硬膜外穿刺等操作;在麻醉过程中实验组患儿血压和脉搏比较平稳;实验组的患儿无论是低年龄段还是高年龄段ICC得分均低于对照组患儿;实验组的患儿术中和术后血清皮质醇浓度与术前比较有显著性减低。这些结果表明心理干预能防止学龄儿童术前、术中的精神紧张,缓解或消除患儿的焦虑情绪,降低围术期前后的血液动力学变化,有助于降低麻醉手术期的应激状态,减轻患儿的应激反应,有效减少围术期全麻药的用量,提高小儿手术麻醉的成功率和围术期的安全性,同时能降低手术患儿对手术的恐惧感,利于术中配合和术后恢复,能缩短医护人员与家长之间的距离,有利于医患关系的改善,并能提高家长满意度。
[Abstract]:Children are extremely frightened, nervous, and anxious about surgical anesthesia; this often leads to increased stress responses before and around surgery, and accidents can occur in severe cases. Due to their immature physical and mental development, children experience a series of stress reactions from psychology to physiology during perioperative period, which not only affect the induction of anesthesia and the smoothness of operation, but also cause psychological and behavioral abnormalities in children during and after operation. As a main method of disease treatment, surgery can relieve the pain of disease and save lives. On the other hand, surgery is a strong stimulus for patients, which can make patients have strong physiological and psychological response. Especially for children, their psychological tolerance is relatively weak, strong psychological stimulation, if not timely dredging, will bring them psychological injury, some even left a psychological shadow, affecting the future study and life. Active psychological intervention to children and family members can shorten the distance between each other, remove worries, reduce strangeness, increase trust, facilitate mutual communication, and help to reduce the children's fear of surgery. Therefore, psychological intervention before and after operation is of great significance to ensure the safety of operation and accelerate the recovery of children. 45 hospitalized children aged 7-14 (without psychological disorders and hypertension, endocrine system diseases and other critical operations) were selected for psychological intervention. To explore the clinical value of psychological intervention in perioperative period of school-age children. The psychological activities of children undergoing anesthesia and their ability to adapt to anesthesia, their effects on body, mind and neuroendocrine system, and the clinical effects of psychological intervention were also discussed. The results showed that the children in the experimental group received psychological intervention after entering the room quiet, can cooperate with preoperative preparation, peripheral vein puncture, blood collection and epidural puncture, etc. The ICC scores of the children in the experimental group were lower than those in the control group, and the serum cortisol concentration in the experimental group was significantly lower than that in the control group. These results suggest that psychological intervention can prevent preoperation and intraoperative stress in school-age children, relieve or eliminate anxiety in children, reduce hemodynamic changes before and after perioperative period, and help to reduce stress state during anaesthesia operation. It can reduce the stress reaction of children, reduce the dosage of general anesthetic in perioperative period, improve the success rate of anesthesia and the safety of perioperative period. At the same time, it can reduce the fear of operation, and is beneficial to the cooperation during operation and the recovery after operation. It can shorten the distance between medical staff and parents, improve the relationship between doctors and patients, and improve the satisfaction of parents.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2006
【分类号】：R395.5
本文编号：2416719
[Abstract]:Children are extremely frightened, nervous, and anxious about surgical anesthesia; this often leads to increased stress responses before and around surgery, and accidents can occur in severe cases. Due to their immature physical and mental development, children experience a series of stress reactions from psychology to physiology during perioperative period, which not only affect the induction of anesthesia and the smoothness of operation, but also cause psychological and behavioral abnormalities in children during and after operation. As a main method of disease treatment, surgery can relieve the pain of disease and save lives. On the other hand, surgery is a strong stimulus for patients, which can make patients have strong physiological and psychological response. Especially for children, their psychological tolerance is relatively weak, strong psychological stimulation, if not timely dredging, will bring them psychological injury, some even left a psychological shadow, affecting the future study and life. Active psychological intervention to children and family members can shorten the distance between each other, remove worries, reduce strangeness, increase trust, facilitate mutual communication, and help to reduce the children's fear of surgery. Therefore, psychological intervention before and after operation is of great significance to ensure the safety of operation and accelerate the recovery of children. 45 hospitalized children aged 7-14 (without psychological disorders and hypertension, endocrine system diseases and other critical operations) were selected for psychological intervention. To explore the clinical value of psychological intervention in perioperative period of school-age children. The psychological activities of children undergoing anesthesia and their ability to adapt to anesthesia, their effects on body, mind and neuroendocrine system, and the clinical effects of psychological intervention were also discussed. The results showed that the children in the experimental group received psychological intervention after entering the room quiet, can cooperate with preoperative preparation, peripheral vein puncture, blood collection and epidural puncture, etc. The ICC scores of the children in the experimental group were lower than those in the control group, and the serum cortisol concentration in the experimental group was significantly lower than that in the control group. These results suggest that psychological intervention can prevent preoperation and intraoperative stress in school-age children, relieve or eliminate anxiety in children, reduce hemodynamic changes before and after perioperative period, and help to reduce stress state during anaesthesia operation. It can reduce the stress reaction of children, reduce the dosage of general anesthetic in perioperative period, improve the success rate of anesthesia and the safety of perioperative period. At the same time, it can reduce the fear of operation, and is beneficial to the cooperation during operation and the recovery after operation. It can shorten the distance between medical staff and parents, improve the relationship between doctors and patients, and improve the satisfaction of parents.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2006
【分类号】：R395.5
【引证文献】
相关硕士学位论文 前1条
1 孟喜军;心理干预在小儿骨科围手术期的应用[D];山西医科大学;2012年
，本文编号：2416719
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