围术期不同护理方法对食管癌患者心理焦虑、抑郁的影响

摘要

目的 探讨围术期不同护理方法对食管癌患者心理焦虑、抑郁的影响.方法 119例食管癌患者随机分为两组,对照组(n=61)行普通护理,试验组(n=58)行舒适护理,通过观测两组患者术前和术后医院焦虑抑郁评分(HAD)、苏醒期躁动发生率、术后镇痛药使用率.对观测指标进行统计分析,比较两种护理的效果.结果 试验组患者焦虑评分[术前(13.23±4.72)比(19.98±5.26)、术后(13.96±4.13)比(19.02±4.39)]、抑郁评分[术前(13.36±3.98)比(20.05±5.08)、术后(12.89±4.17)比(18.91±4.91)]均显著低于对照组(P<0.01);术后苏醒期躁动发生率试验组低于对照组(31.03％ 比50.82％,P<0.01);术后镇痛药使用率试验组低于对照组(44.83％ 比67.21％,P<0.05).结论 食管癌患者围术期术前、术后存在心理焦虑抑郁等状况,舒适护理能有效缓解食管癌手术患者术前、术后的焦虑抑郁状况、降低术后苏醒期躁动发生率、减少术后镇痛药的使用率.%Objective To investigate the effects of different nursing methods on psychological anxiety and depression of patients with esophageal cancer in the perioperative period. Methods 119 patients with esophageal cancer were randomly divided into two groups. The control group (n=61) was given general nursing while the test group (n=58) was given comfortable nursing. The hospital anxiety and depression score (HAD) before and after operation, the incidence of restlessness, and the usage rate of postoperative analgesics were observed in the two groups. The statistical analysis of the observation indexes was carried out to compare the effect of two kinds of nursing methods. Results The anxiety score [preoperative (13.23±4.72) and postoperative (13.96±4.13)] and the depression score [preoperative (13.36±3.98) and postoperative (12.89±4.17)] of the test group were significantly lower than those of the control group [preoperative anxiety score (19.98±5.26) and postoperative anxiety score (19.02±4.39), preoperative depression score (20.05±5.08) and postoperative depression score (18.91±4.91)] (P<0.01). The incidence of postoperative restlessness in the test group (31.03％) was lower than that in the control group (50.82％) (P<0.01). The usage rate of postoperative analgesics of the test group (44.83％) was lower than that of the control group (67.21％) (P<0.05). Conclusions Psychological anxiety and depression exist in patients with esophageal cancer in the perioperative period. Comfortable nursing can effectively relieve anxiety and depression in patients with esophageal cancer before and after operation, reduce the incidence of postoperative restlessness and the usage rate of postoperative analgesics.