本文選題：麻醉 + 全身/護(hù)理�。� 參考：《臨床護(hù)理雜志》2016年05期

【摘要】：目的分析全麻患者術(shù)中知曉及術(shù)后心理狀態(tài),并提出有效的護(hù)理對策。方法將我院行全麻手術(shù)患者900例進(jìn)行術(shù)中知曉問卷調(diào)查分析,對發(fā)生術(shù)中知曉患者在術(shù)后1周采用SCL-90量表進(jìn)行調(diào)查,觀察患者術(shù)后心理狀況。結(jié)果900例全麻手術(shù)患者中30例存在懷疑有知曉,18例患者確定存在術(shù)中知曉,其中9例感知疼痛,1例疼痛劇烈,3例在手術(shù)開始時疼痛相對輕微,3例在皮膚縫合時稍有疼痛,2例手術(shù)過程中出現(xiàn)恐懼、焦慮和瀕死感。懷疑知曉患者在軀體化、強(qiáng)迫癥狀、人際關(guān)系敏感、偏執(zhí)、精神病性維度評分及均分、總分均高于全國常模,有顯著性差異(P0.05);確定有知曉患者在軀體化、人際關(guān)系敏感、抑郁、焦慮、恐怖、偏執(zhí)、精神病性維度評分及均分、總分均高于全國常模,有顯著性差異(P0.05);確定有知曉患者和懷疑知曉患者在強(qiáng)迫癥狀、抑郁、焦慮、恐怖維度評分比較,有顯著性差異(P0.05)。結(jié)論全麻手術(shù)過程中存在術(shù)中知曉嚴(yán)重影響了患者心理狀態(tài),應(yīng)充分評估患者術(shù)中知曉危險因素,加強(qiáng)與患者溝通,通過積極的護(hù)理干預(yù)措施,降低術(shù)中知曉對患者的影響。
[Abstract]:Objective to analyze the mental state of patients with general anesthesia during and after operation, and to put forward effective nursing countermeasures. Methods 900 patients undergoing general anesthesia in our hospital were investigated with SCL-90 scale 1 week after operation, and their psychological status was observed. Results among 900 patients undergoing general anesthesia, 30 patients were suspected to have known and 18 patients were confirmed to have intraoperative knowledge. Of them, 9 cases had severe pain, 1 case had severe pain, 3 cases had relatively mild pain at the beginning of operation, 3 cases had slight pain during skin suture, 2 cases had fear, anxiety and near-death feeling during operation. The scores and mean scores of somatization, obsessive-compulsive symptoms, interpersonal sensitivity, paranoid ideation, psychotic dimension and the total score of the patients were higher than those of the national norm (P 0.05). The scores of anxiety, phobia, paranoid ideation, psychotic dimension and total score were all higher than the national norm (P 0.05). The scores of obsessive-compulsive symptoms, depression, anxiety and phobia were compared between those who knew and those who were suspected to know. There was significant difference (P 0.05). Conclusion Intraoperative knowledge has a serious effect on the psychological state of patients during general anesthesia operation. It is necessary to fully evaluate the risk factors of knowing during operation, strengthen communication with patients, and reduce the influence of intraoperative knowledge on patients through active nursing intervention.
【作者單位】： 湖北省武漢市武東醫(yī)院;
【分類號】：R473.6

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