心理干预在预防全身麻醉苏醒期导尿相关膀胱刺激症中的应用
发布时间：2018-10-12 09:00
【摘要】：目的：观察心理干预对全身麻醉苏醒期患者导尿相关膀胱刺激症(CRBD)的防治效果,以及心理干预的合适时机。 方法：将240例全麻下骨科、普外科择期手术患者,随机分为四组,每组各60例,A组：术前一天麻醉访视时行心理干预；B组：术前一天和麻醉诱导前行心理干预各一次；C组：麻醉诱导前心理干预一次；D组：观察组。各组常规访视谈话签字,均在全麻诱导后行导尿术,所有患者麻醉诱导方式相同,进行机械控制呼吸后采用全凭静脉麻醉维持。记录研究对象麻醉诱导前(To)和术后麻醉苏醒拔管时(T1)及拔管后行躁动评分时(T2)的平均动脉压(MAP)、心率(HR)；同时记录患者的麻醉时间、苏醒时间和拔管时间；拔管后待患者意识清醒(能准确回答问题)后行躁动评分、VAS评分、膀胱刺激程度分级。比较四组患者在全身麻醉苏醒期因导尿管相关的重度CRBD。 结果： 1、四组患者在性别、年龄、身高、体重、麻醉时间、苏醒时间、拔管时间上差异无统计学意义(P0.05)； 2、入室时(T0)MAP、心率四组均值无统计学意义,拔管时(T1)A、B、C三组低于D组(p0.05)有统计学意义,B组略低于A、C组,但无统计学意义,躁动评分时(T2)和入室时(T0)MAP、心率四组均值(p0.05)无统计学意义。 3、A、B、C三组与D组相比全麻苏醒后躁动率有统计学意义,前三组躁动率明显低于D组；B组略低于A、C组,但无统计学意义；A、C组相比无统计学意义；四组VAS相比无统计学意义。 4、A、B、C三组于D组相比重度CRBD (p0.05)的发生率有统计学意义,B组低于A、C组但没有统计学意义,A、C组相比无统计学意义。A、B、C三组与D组相比轻度的明显增多,有统计学意义,B组较A、C组更明显但没有统计学意义。 结论： 1、术前心理干预后苏醒期导尿相关的重度CRBD发生率显著降低,而且心血管不良事件的发生率也有所减少,轻度CRBD显著增多,明显降低患者全麻苏醒期导尿相关CRBD的不适。 2、实施心理干预的合适方法是术前一天实施一次,麻醉诱导前再加强一次。
[Abstract]:Objective: to observe the effect of psychological intervention on the prevention and treatment of (CRBD) in patients with urinary catheterization associated with bladder irritation during general anesthesia recovery and the appropriate time of psychological intervention. Methods: 240 patients undergoing orthopedic and general surgery under general anesthesia were randomly divided into four groups: group A: psychological intervention during anaesthesia visit one day before operation, group B: psychological intervention one day before operation and one intervention before anesthesia induction; Group C: psychological intervention once before anesthesia induction, group D: observation group. After induction of general anesthesia, all patients were given urethral catheterization. All patients had the same anaesthesia induction mode, and all patients were maintained by total intravenous anesthesia after mechanical control of breathing. The mean arterial pressure (MAP),) heart rate (HR);) of (To) before anesthesia induction and after anesthesia recovery and extubation (T1) and restlessness score (T2) after extubation were recorded. The anesthesia time, recovery time and extubation time were recorded at the same time. After the extubation, the patients were conscious (who could answer the questions accurately) and then they were graded with restlessness, VAS and bladder irritation. Comparison of four groups of patients with severe CRBD. associated with urethral catheter during general anesthesia recovery Results: 1. There was no significant difference in sex, age, height, weight, anaesthesia time, recovery time and extubation time between the four groups (P0.05); During extubation, there was statistical significance in group C (T1) compared with group D (p0.05), group B was lower than group A (P 0.05), but there was no significant difference between group B and group A (P 0.05). There was no significant difference in the mean value of MAP, heart rate among the four groups (p0. 05) at the time of restlessness score (T2) and (T0). 3 the restlessness rate of group C was significantly lower than that of group D after general anesthesia, and the restlessness rate of group B was lower than that of group D, and that of group B was slightly lower than that of group C. But there was no statistical significance, there was no statistical significance in group A and C, but there was no significant difference between group A and C. The incidence of severe CRBD in group C was significantly higher than that in group D, but there was no significant difference between group B and group A, but there was no significant difference between group C and group A. the incidence of severe CRBD in group C was significantly higher than that in group D, but there was no significant difference between group A and group C. the incidence of severe CRBD in group C was significantly higher than that in group D, but there was no significant difference between group A and group C. There was a slight increase, There was statistical significance, group B was more obvious than group A C, but had no statistical significance. Conclusion: 1. The incidence of severe CRBD associated with urethral catheterization was significantly decreased, the incidence of adverse cardiovascular events was also decreased, and the incidence of mild CRBD was significantly increased after psychological intervention. The discomfort of urethral catheterization associated with CRBD was significantly reduced during general anesthesia recovery. 2. The appropriate method of psychological intervention was once a day before anesthesia induction and once more before anesthesia induction.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R614
本文编号：2265545
[Abstract]:Objective: to observe the effect of psychological intervention on the prevention and treatment of (CRBD) in patients with urinary catheterization associated with bladder irritation during general anesthesia recovery and the appropriate time of psychological intervention. Methods: 240 patients undergoing orthopedic and general surgery under general anesthesia were randomly divided into four groups: group A: psychological intervention during anaesthesia visit one day before operation, group B: psychological intervention one day before operation and one intervention before anesthesia induction; Group C: psychological intervention once before anesthesia induction, group D: observation group. After induction of general anesthesia, all patients were given urethral catheterization. All patients had the same anaesthesia induction mode, and all patients were maintained by total intravenous anesthesia after mechanical control of breathing. The mean arterial pressure (MAP),) heart rate (HR);) of (To) before anesthesia induction and after anesthesia recovery and extubation (T1) and restlessness score (T2) after extubation were recorded. The anesthesia time, recovery time and extubation time were recorded at the same time. After the extubation, the patients were conscious (who could answer the questions accurately) and then they were graded with restlessness, VAS and bladder irritation. Comparison of four groups of patients with severe CRBD. associated with urethral catheter during general anesthesia recovery Results: 1. There was no significant difference in sex, age, height, weight, anaesthesia time, recovery time and extubation time between the four groups (P0.05); During extubation, there was statistical significance in group C (T1) compared with group D (p0.05), group B was lower than group A (P 0.05), but there was no significant difference between group B and group A (P 0.05). There was no significant difference in the mean value of MAP, heart rate among the four groups (p0. 05) at the time of restlessness score (T2) and (T0). 3 the restlessness rate of group C was significantly lower than that of group D after general anesthesia, and the restlessness rate of group B was lower than that of group D, and that of group B was slightly lower than that of group C. But there was no statistical significance, there was no statistical significance in group A and C, but there was no significant difference between group A and C. The incidence of severe CRBD in group C was significantly higher than that in group D, but there was no significant difference between group B and group A, but there was no significant difference between group C and group A. the incidence of severe CRBD in group C was significantly higher than that in group D, but there was no significant difference between group A and group C. the incidence of severe CRBD in group C was significantly higher than that in group D, but there was no significant difference between group A and group C. There was a slight increase, There was statistical significance, group B was more obvious than group A C, but had no statistical significance. Conclusion: 1. The incidence of severe CRBD associated with urethral catheterization was significantly decreased, the incidence of adverse cardiovascular events was also decreased, and the incidence of mild CRBD was significantly increased after psychological intervention. The discomfort of urethral catheterization associated with CRBD was significantly reduced during general anesthesia recovery. 2. The appropriate method of psychological intervention was once a day before anesthesia induction and once more before anesthesia induction.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R614
【共引文献】
相关期刊论文 前1条
1 刘亚丽,杨川;围手术期健康宣教的现状与思考[J];实用医技;2001年05期
相关硕士学位论文 前1条
1 胡玉翠;心理干预在老年麻醉中的应用研究[D];山东大学;2008年
，本文编号：2265545
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