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    围术期心理干预对全麻下行乳腺癌切除术患者术后恢复的影响

    Clinical observation of perioperative psychological intervention on postoperative recovery of patients undergoing breast cancer resection under general anesthesia

    • 摘要: 目的 探讨围术期心理干预对全麻下行乳腺癌切除术患者术后焦虑、抑郁的影响。方法 选取2022年10月-2022年12月接受全麻下行乳腺癌改良根治术女性患者110例。术前2 d采用随机数字表法将受试者随机分配到SM组、SA组。SA组为常规管理组;SM组为心理干预组,该组患者将接受5次心理干预,分别为术前2 d、术前1 d、手术当天、术后1 d及术后2 d,每次30 min。比较2组患者术后24 h、72 h、30 d的状态焦虑量表(SAI)和蒙哥马利抑郁评定量表(MADRS)评分。结果 与SA组相比,SM组入室时(T1)的心率(HR)较低(P<0.05),T1及切皮时(T3)的平均动脉压(MAP)较低(P<0.05)。SM组术中去氧肾上腺素使用率较低(P=0.017),术后恶心、呕吐的发生率较低(P=0.023),术后24 h、72 h圣玛丽医院睡眠问卷(SMH)评分显著增高(P<0.05),术后72 h的视觉模拟量表(VAS)评分显著降低(P<0.05)。SM组术后72 h的SAI评分较SA组显著降低(P<0.05),但2组术后各时间点MADRS评分的差异无统计学意义(P>0.05)。结论 围术期心理干预可以缓解全麻下行乳腺癌切除术患者术后焦虑情绪,降低术后恶心、呕吐的发生率,改善术后睡眠质量并减轻术后疼痛。

       

      Abstract: Objective To investigate the effect of perioperative psychological intervention on postoperative anxiety and depression in patients undergoing breast cancer resection under general anesthesia.Methods A total of 110 female patients who were scheduled for breast cancer resection under general anesthesia between October 2022 and December 2022 were enrolled. Two days before surgery, they were randomly divided into two groups according to the random number table method:a psychological intervention group (group SM) or a general care group (group SA). Patients in group SM received psychological intervention for five times, 30 min each time, two days before surgery, one day before surgery, on the day of surgery, on postoperative 1 day and 2 days. Two groups were compared for the State Anxiety Scale (SAI) and Montgomery Depression Rating Scale (MADRS) scores at postoperative 24 h, 72 h and 30 days.Results Compared with group SA, group SM showed decreases in heart rate (HR) at T1 (at entering into the operating room) and mean arterial pressure (MAP) at T1 and T3 (when incising the skin) (P<0.05). Group SM presented a decreased usage rate of phenylephrine (P=0.017), increased St. Mary's Hospital Sleep Questionnaire (SMH) scores at postoperative 24 h and 72 h (P<0.05) and reduced visual analogue scale (VAS) scores at postoperative 72 h (P<0.05), with a low incidence of postoperative nausea and vomiting (P=0.023). The SAI scores at postoperative 72 h in group SM were significantly lower than those in group SA (P<0.05), but there were no statistical difference in MADRS score at each postoperative time point between the groups (P>0.05).Conclusions Perioperative psychological intervention relieve postoperative anxiety in patients undergoing breast cancer resection under general anesthesia, reduces the incidence of postoperative nausea and vomiting, improve sleep quality and reduces postoperative pain.

       

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