全麻患者术中知晓与术后心理状况分析及护理对策

发布时间：2018-06-08 16:31

本文选题：麻醉 + 全身/护理　；参考：《临床护理杂志》2016年05期

【摘要】：目的分析全麻患者术中知晓及术后心理状态,并提出有效的护理对策。方法将我院行全麻手术患者900例进行术中知晓问卷调查分析,对发生术中知晓患者在术后1周采用SCL-90量表进行调查,观察患者术后心理状况。结果900例全麻手术患者中30例存在怀疑有知晓,18例患者确定存在术中知晓,其中9例感知疼痛,1例疼痛剧烈,3例在手术开始时疼痛相对轻微,3例在皮肤缝合时稍有疼痛,2例手术过程中出现恐惧、焦虑和濒死感。怀疑知晓患者在躯体化、强迫症状、人际关系敏感、偏执、精神病性维度评分及均分、总分均高于全国常模,有显著性差异(P0.05);确定有知晓患者在躯体化、人际关系敏感、抑郁、焦虑、恐怖、偏执、精神病性维度评分及均分、总分均高于全国常模,有显著性差异(P0.05);确定有知晓患者和怀疑知晓患者在强迫症状、抑郁、焦虑、恐怖维度评分比较,有显著性差异(P0.05)。结论全麻手术过程中存在术中知晓严重影响了患者心理状态,应充分评估患者术中知晓危险因素,加强与患者沟通,通过积极的护理干预措施,降低术中知晓对患者的影响。
[Abstract]:Objective to analyze the mental state of patients with general anesthesia during and after operation, and to put forward effective nursing countermeasures. Methods 900 patients undergoing general anesthesia in our hospital were investigated with SCL-90 scale 1 week after operation, and their psychological status was observed. Results among 900 patients undergoing general anesthesia, 30 patients were suspected to have known and 18 patients were confirmed to have intraoperative knowledge. Of them, 9 cases had severe pain, 1 case had severe pain, 3 cases had relatively mild pain at the beginning of operation, 3 cases had slight pain during skin suture, 2 cases had fear, anxiety and near-death feeling during operation. The scores and mean scores of somatization, obsessive-compulsive symptoms, interpersonal sensitivity, paranoid ideation, psychotic dimension and the total score of the patients were higher than those of the national norm (P 0.05). The scores of anxiety, phobia, paranoid ideation, psychotic dimension and total score were all higher than the national norm (P 0.05). The scores of obsessive-compulsive symptoms, depression, anxiety and phobia were compared between those who knew and those who were suspected to know. There was significant difference (P 0.05). Conclusion Intraoperative knowledge has a serious effect on the psychological state of patients during general anesthesia operation. It is necessary to fully evaluate the risk factors of knowing during operation, strengthen communication with patients, and reduce the influence of intraoperative knowledge on patients through active nursing intervention.
【作者单位】：湖北省武汉市武东医院;
【分类号】：R473.6

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