心理干预联合药物多模式治疗用于骨科镇痛效果与应激反应的研究

摘要

Objective To explore the effect of psychological intervention combined with drug multimodal therapy on orthopedic analgesia and its effect on stress response, and to provide reference for clinical application.Methods 88 cases treated with open reduction and internal fixation for lower limb fracture as the object of study were collected from March 2015 to March 2017 in Baoji traditional Chinese medicine hospital, which were received multi-mode drug treatment.According to whether to receive psychological intervention, 88cases were divided into the intervention group(45 cases) and the control group(43 cases).Postoperative pain was assessed by visual analogue scale(VAS) and simplified McGill questionnaire(SF-MPQ), the changes of plasma CRP and IL-6 levels were compared before and after operation.Results There was no significant difference in VAS score, SF-MPQ score, preoperative plasma CRP and IL-6 levels between the two groups.One and 24 hour after operation, VAS score and SF-MPQ score were higher than those at admission(P<0.05).The VAS score and SF-MPQ score in the intervention group were lower than those in the control group at different time points(P<0.05).One and 24 hour after operation, plasma CRP and IL-6 levels in the two groups were significantly higher than those before operation(P<0.05), the levels of plasma CRP and IL-6 in the intervention group were significantly lower than those in the control group(P<0.05).Conclusion Psychological intervention combined with multimodal drug therapy can effectively reduce the degree of postoperative pain and stress reaction, and is conducive to postoperative rehabilitation.%目的 探讨心理干预联合药物多模式治疗用于骨科镇痛的效果及其对应激反应的影响,为临床应用提供参考.方法 收集2015年3月～2017年3月宝鸡市中医医院骨一科收治择期行下肢骨折切开复位内固定术治疗的88例患者作为研究对象,均采用药物多模式治疗,按是否接受心理干预分为干预组(共45例)和对照组(共43例).采用视觉模拟评分法(VAS)与简化的McGill问卷(SF-MPQ)评价术后疼痛情况,比较手术前后患者血浆CRP和IL-6水平的变化情况.结果 2组患者入院时VAS评分、SF-MPQ评分、术前血浆CRP和IL-6水平比较均无统计学差异,术后1h、术后24hVAS评分、SF-MPQ评分均较入院时明显下降(P＜0.05),干预组术后不同时点VAS评分、SF-MPQ评分均低于对照组(P＜0.05).2组术后1 h、术后24 h血浆CRP和IL-6水平均较治疗前升高(P＜0.05),但干预组血浆CRP和IL-6水平升高幅度明显小于对照组,比较有统计学差异(P＜0.05).结论 心理干预联合药物多模式治疗可有效减轻其术后疼痛程度和应激反应,利于术后康复.