心理干預(yù)在學(xué)齡兒童圍手術(shù)期的應(yīng)用
發(fā)布時間：2019-01-27 21:32
【摘要】： 兒童對手術(shù)麻醉極為恐懼、緊張和焦慮;這往往會引起麻醉前和圍手術(shù)期應(yīng)激反應(yīng)增強,嚴(yán)重者可發(fā)生意外。兒童因其身心發(fā)育不成熟,在圍手術(shù)期會經(jīng)歷從心理到生理的一系列應(yīng)激反應(yīng),不僅影響麻醉誘導(dǎo)和手術(shù)的平順,還會造成兒童術(shù)中、術(shù)后不同程度的心理和行為異常。手術(shù)作為一種主要的疾病治療手段,一方面能給病人解除疾病的痛苦,挽救生命;另一方面,手術(shù)對患者來說是一種強烈的刺激源,可使患者產(chǎn)生較強的生理與心理反應(yīng)。特別是對兒童而言,他們的心理承受力較弱,較強的心理刺激如不及時疏導(dǎo),會給他們帶來心理傷害,有的甚至留下心理陰影,影響以后的學(xué)習(xí)和生活。積極主動對患兒和家屬進行心理干預(yù),可縮短彼此的距離,消除顧慮,減少陌生感,增加信任,便于相互溝通,更利于減輕患兒對手術(shù)的恐懼感。因此,兒童手術(shù)前后的心理干預(yù)對保證手術(shù)安全,加快患兒身體恢復(fù)有重要意義。 本文選擇45例擇期手術(shù)的7-14歲住院兒童(無心理、精神障礙和高血壓、內(nèi)分泌系統(tǒng)疾病及其他危重手術(shù)等)對其進行心理干預(yù);用以探討心理干預(yù)在學(xué)齡兒童圍術(shù)期應(yīng)用的臨床價值,以及麻醉手術(shù)過程患兒的心理活動和這些心理活動對兒童適應(yīng)麻醉的能力及其對身心及神經(jīng)-內(nèi)分泌系統(tǒng)的影響以及給予心理干預(yù)后產(chǎn)生的臨床效果。結(jié)果表明接受心理干預(yù)實驗組患兒入室后安靜,能配合術(shù)前準(zhǔn)備、外周靜脈穿刺、采血及硬膜外穿刺等操作;在麻醉過程中實驗組患兒血壓和脈搏比較平穩(wěn);實驗組的患兒無論是低年齡段還是高年齡段ICC得分均低于對照組患兒;實驗組的患兒術(shù)中和術(shù)后血清皮質(zhì)醇濃度與術(shù)前比較有顯著性減低。這些結(jié)果表明心理干預(yù)能防止學(xué)齡兒童術(shù)前、術(shù)中的精神緊張,緩解或消除患兒的焦慮情緒,降低圍術(shù)期前后的血液動力學(xué)變化,有助于降低麻醉手術(shù)期的應(yīng)激狀態(tài),減輕患兒的應(yīng)激反應(yīng),有效減少圍術(shù)期全麻藥的用量,提高小兒手術(shù)麻醉的成功率和圍術(shù)期的安全性,同時能降低手術(shù)患兒對手術(shù)的恐懼感,利于術(shù)中配合和術(shù)后恢復(fù),能縮短醫(yī)護人員與家長之間的距離,有利于醫(yī)患關(guān)系的改善,并能提高家長滿意度。
[Abstract]:Children are extremely frightened, nervous, and anxious about surgical anesthesia; this often leads to increased stress responses before and around surgery, and accidents can occur in severe cases. Due to their immature physical and mental development, children experience a series of stress reactions from psychology to physiology during perioperative period, which not only affect the induction of anesthesia and the smoothness of operation, but also cause psychological and behavioral abnormalities in children during and after operation. As a main method of disease treatment, surgery can relieve the pain of disease and save lives. On the other hand, surgery is a strong stimulus for patients, which can make patients have strong physiological and psychological response. Especially for children, their psychological tolerance is relatively weak, strong psychological stimulation, if not timely dredging, will bring them psychological injury, some even left a psychological shadow, affecting the future study and life. Active psychological intervention to children and family members can shorten the distance between each other, remove worries, reduce strangeness, increase trust, facilitate mutual communication, and help to reduce the children's fear of surgery. Therefore, psychological intervention before and after operation is of great significance to ensure the safety of operation and accelerate the recovery of children. 45 hospitalized children aged 7-14 (without psychological disorders and hypertension, endocrine system diseases and other critical operations) were selected for psychological intervention. To explore the clinical value of psychological intervention in perioperative period of school-age children. The psychological activities of children undergoing anesthesia and their ability to adapt to anesthesia, their effects on body, mind and neuroendocrine system, and the clinical effects of psychological intervention were also discussed. The results showed that the children in the experimental group received psychological intervention after entering the room quiet, can cooperate with preoperative preparation, peripheral vein puncture, blood collection and epidural puncture, etc. The ICC scores of the children in the experimental group were lower than those in the control group, and the serum cortisol concentration in the experimental group was significantly lower than that in the control group. These results suggest that psychological intervention can prevent preoperation and intraoperative stress in school-age children, relieve or eliminate anxiety in children, reduce hemodynamic changes before and after perioperative period, and help to reduce stress state during anaesthesia operation. It can reduce the stress reaction of children, reduce the dosage of general anesthetic in perioperative period, improve the success rate of anesthesia and the safety of perioperative period. At the same time, it can reduce the fear of operation, and is beneficial to the cooperation during operation and the recovery after operation. It can shorten the distance between medical staff and parents, improve the relationship between doctors and patients, and improve the satisfaction of parents.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2006
【分類號】：R395.5
本文編號：2416719
[Abstract]:Children are extremely frightened, nervous, and anxious about surgical anesthesia; this often leads to increased stress responses before and around surgery, and accidents can occur in severe cases. Due to their immature physical and mental development, children experience a series of stress reactions from psychology to physiology during perioperative period, which not only affect the induction of anesthesia and the smoothness of operation, but also cause psychological and behavioral abnormalities in children during and after operation. As a main method of disease treatment, surgery can relieve the pain of disease and save lives. On the other hand, surgery is a strong stimulus for patients, which can make patients have strong physiological and psychological response. Especially for children, their psychological tolerance is relatively weak, strong psychological stimulation, if not timely dredging, will bring them psychological injury, some even left a psychological shadow, affecting the future study and life. Active psychological intervention to children and family members can shorten the distance between each other, remove worries, reduce strangeness, increase trust, facilitate mutual communication, and help to reduce the children's fear of surgery. Therefore, psychological intervention before and after operation is of great significance to ensure the safety of operation and accelerate the recovery of children. 45 hospitalized children aged 7-14 (without psychological disorders and hypertension, endocrine system diseases and other critical operations) were selected for psychological intervention. To explore the clinical value of psychological intervention in perioperative period of school-age children. The psychological activities of children undergoing anesthesia and their ability to adapt to anesthesia, their effects on body, mind and neuroendocrine system, and the clinical effects of psychological intervention were also discussed. The results showed that the children in the experimental group received psychological intervention after entering the room quiet, can cooperate with preoperative preparation, peripheral vein puncture, blood collection and epidural puncture, etc. The ICC scores of the children in the experimental group were lower than those in the control group, and the serum cortisol concentration in the experimental group was significantly lower than that in the control group. These results suggest that psychological intervention can prevent preoperation and intraoperative stress in school-age children, relieve or eliminate anxiety in children, reduce hemodynamic changes before and after perioperative period, and help to reduce stress state during anaesthesia operation. It can reduce the stress reaction of children, reduce the dosage of general anesthetic in perioperative period, improve the success rate of anesthesia and the safety of perioperative period. At the same time, it can reduce the fear of operation, and is beneficial to the cooperation during operation and the recovery after operation. It can shorten the distance between medical staff and parents, improve the relationship between doctors and patients, and improve the satisfaction of parents.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2006
【分類號】：R395.5
【引證文獻】
相關(guān)碩士學(xué)位論文 前1條
1 孟喜軍;心理干預(yù)在小兒骨科圍手術(shù)期的應(yīng)用[D];山西醫(yī)科大學(xué);2012年
，本文編號：2416719
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