目的:探讨治疗性抚触为主的综合护理干预对甲状腺手术患者围术期应激反应的影响.方法:选择72例择期行甲状腺手术患者,随机分为干预组和对照组各36例,对照组施行常规术前护理模式,干预组在对照组基础上施行综合护理干预和治疗性抚触,观察两组患者手术前、麻醉前、切皮时、分离肿物时、术后2h和6h患者收缩压(SBP)、舒张压(DBP)和心率(HR)；手术结束后询问患者自觉疼痛程度,于术后2h和6 h测定患者视觉拟疼痛评分(VAS)；记录两组患者出现稍有不适、轻微疼痛、明显疼痛但能忍受以及明显疼痛不能忍受的例数.结果:干预组患者切皮时和分离时DBP、SBP和HT均低于对照组(P＜0.05)；术后VAS评分低于对照组(P＜0.05)；出现明显疼痛不能忍受的发生率低于对照组(P＜0.05).结论:治疗性抚触和综合护理干预可明显缓解甲状腺手术患者术中和术后疼痛,保持术中血流动力学的稳定,有效缓解甲状腺手术患者的手术应激.%Objective:To explore the therapeutic touch consisting mainly of comprehensive nursing intervention on thyroid operation in peri - operative patients with stress reaction. Methods:72 patients undergoing thyroid operation were randomly divided into intervention group and control group,36 cases in each group. The routine preoperan've nursing mode was given to the control group, but effective nursing interventions and therapeutic touch were given to the intervention group on the basis of the control group. To observe and test systolic blood pressure ( SBP) , diastolic blood pressure ( DBP) and heart rate ( HR) before operation, anesthesia, skin incision, separation, postoperative 2 h and 6 h. The VAS pain score of patients should be determined within 2 h and 6 h after operation. The cases experiencing slight discomfort, mild pain, obvious pain but can tolerate and obvious pain but can not bear were recorded. Results: The DBP, SBP and HR of the intervention group were significantly lower than those in the control group ( P < 0.05 ) during skin incision and separation. The VAS score of the intervention group was significantly lower than that of the control group (P < 0.05 ) after operation. The cases of obvious pain but can not bear in the intervention group was significantly lower than that of control group (P < 0.05 ). Conclusions: The therapeutic touch and mental nursing intervention can obviously alleviate the pain of patients with thyroid during operative and postoperative period, effectively maintain the stability of hemodynamics during operation and alleviate the stress of operation.
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