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Received:May 12, 2023 Published Online:January 20, 2024
Received:May 12, 2023 Published Online:January 20, 2024
中文摘要: 目的 观察腹腔镜肝切除术患者实施无痛理念下认知行为干预对其疼痛评分及心理状态的影响。
方法 选取2020年1月至2022年12月在新疆医科大学第一附属医院拟行腹腔镜肝切除术治疗的98例肝癌患者为研究对象，按随机数字表法分为观察组和对照组，每组49例。对两组均实施常规围手术期护理干预，观察组联合实施无痛理念下认知行为干预。比较两组简化McGill疼痛问卷（SF-MPQ）、心理困扰筛查工具、15项恢复质量量表（QoR-15）评定结果，以及首次下床活动时间、肛门排气时间、住院时间、不良事件发生情况。
结果 两组SF-MPQ各分量表得分、QoR-15得分、心理困扰筛查工具问题列表（PL）中生理、情绪维度得分比较差异有统计学意义（P＜0.05），观察组表现更佳；术后24 h、3 d、7 d时观察组心理困扰阳性率低于对照组（χ2=5.014、4.460、4.141，P＜0.05）；观察组首次下床活动时间、肛门排气时间、住院时间均短于对照组（t=4.409、8.066、3.300，P＜0.01）。两组消化道不适、尿潴留、头晕发生率比较差异无统计学意义（χ2=0.800、0.122、0.710，P>0.05）。
结论 无痛理念下认知行为干预有助于降低腹腔镜肝切除术患者术后疼痛，缓解其心理困扰，对促进恢复有积极作用。
Abstract:Objective To observe the impact of implementing painless cognitive behavioral intervention on pain score and psychological state in patients undergoing laparoscopic hepatectomy.
Methods Ninety-eight patients with liver cancer who planned to receive laparoscopic hepatectomy in the First Affiliated Hospital of Xinjiang Medical University from January 2020 to December 2022 were recruited as research subjects, and were divided into observation group and control group according to the random number table method, with 49 cases in each group. Routine perioperative nursing intervention was performed in both groups, and cognitive behavioral intervention under painless concept was jointly implemented in observation group. The scores of short-form McGill Pain Questionnaire (SF-MPQ), Psychological Distress Screening Tool and 15-item Quality of Recovery Scale (QoR-15), and the time of first getting out of bed, anal exhaust, and hospital stay, as well as occurrence of adverse events were compared between the two groups.
Results There were statistically significant differences in scores of SF-MPQ, QoR-15 and physiological dimension and emotional dimension of Psychological Distress Screening Tool problem list (PL) between the two groups (P＜0.05), with observation group performing better. The positive rate of psychological distress in observation group was lower than that in control group at 24 h, 3 d and 7 d after surgery (χ2=5.014, 4.460, 4.141, P＜0.05). The time of first getting out of bed, anal exhaust and hospital stay were shorter in observation group than those in control group (t=4.409, 8.066, 3.300, P＜0.01), while there was no statistical difference in the incidence rates of digestive tract discomfort, urinary retention and dizziness between two groups (χ2=0.800, 0.122, 0.710, P>0.05).
Conclusion Cognitive behavioral intervention under painless concept is helpful to reduce the postoperative pain and relieve the psychological distress in patients with laparoscopic hepatectomy, and has a positive effect on promoting recovery.
keywords: Liver cancer Laparoscopic hepatectomy Painless concept Cognitive behavioral intervention Postoperative pain Psychological distress Postoperative recovery
文章编号： 中图分类号：R473. 73 文献标志码：B
基金项目:新疆维吾尔自治区自然科学基金面上项目（2021D01C304）；新疆维吾尔自治区护理学会项目（2023XH016,2023XH020）
| Author Name | Affiliation |
| SONG Huixia, SONG Yinghua, GU Shenseng | Department of Laparoscopic Liver Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830000, China |
| Author Name | Affiliation |
| SONG Huixia, SONG Yinghua, GU Shenseng | Department of Laparoscopic Liver Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830000, China |
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