多模式预防性镇痛联合正性心理干预对肝癌患者术后康复疗效的影响(1)
[摘要] 目的 探討多模式预防性镇痛联合正性心理干预对肝癌患者术后康复疗效的影响。 方法 选取2018年12月～2019年12月锦州医科大学附属第一医院80例肝癌手术患者，随机分为观察组及对照组。术前评估患者心理状态，观察组在此基础上予以心理干预。术中观察组切皮前5～10 min用0.25%罗哌卡因20 mL在切口周围进行逐层浸润麻醉，浸润深度为皮下至腹膜层。术后对照组使用自控式静脉镇痛泵镇痛;观察组连续3 d肌注帕瑞昔布钠，每日2次，20 mg/次，并且对患者进行心理干预。比较两组患者术后同期疼痛程度、术后康复指标、肝功、凝血恢复情况以及心理状态。 结果 观察组患者术后同期NRS疼痛评分低于对照组，差异有统计学意义(P<0.05)。观察组术后康复指标优于对照组，差异有统计学意义(P<0.05)。两组患者术前肝功、凝血指标差异无统计学意义(P>0.05);术后第3天观察组肝功、凝血均优于对照组，差异有统计学意义(P<0.05)。两组患者术前SAS、SDS评分差异无统计学意义(P>0.05);术后两组评分均下降且观察组SAS、SDS评分均低于对照组，差异有统计学意义(P<0.05)。 结论 多模式预防性镇痛联合正性心理干预可以使肝癌患者术后疼痛得到安全、有效控制，促进术后肝功、凝血恢复，缓解患者术后焦虑、抑郁情绪，加快术后康复进程。
[关键词] 多模式预防性镇痛;正性心理干预;肝癌;术后康复
[中图分类号] R735.7 [文献标识码] B [文章编号] 1673-9701(2020)21-0058-06
Impacts of multi-mode preventive analgesia combined with positive psychological intervention on postoperative rehabilitation of liver cancer patients
ZHANG Yifan WANG Wei
Department of General Surgery， the First Affiliated Hospital of Jinzhou Medical University， Jinzhou 121000， China
[Abstract] Objective To investigate the impacts of multi-mode preventive analgesia combined with positive psychological intervention on postoperative rehabilitation of liver cancer patients. Methods From December 2018 to December 2019， 80 patients undergoing liver cancer surgery in the First Affiliated Hospital of Jinzhou Medical University were randomly divided into the observation group and the control group. The psychological state of the patients was evaluated at baseline， and the observation group was given psychological intervention on this basis. Intraoperatively， the observation group was anesthetized with 0.25% ropivacaine 20 mL layer by layer around the incision 5-10 min before skin incision， and the depth of infiltration was from subcutaneous to peritoneal layer. The postoperative control group was treated with self-controlled intravenous analgesia pump. The observation group received an intramuscular injection of parecoxib sodium for three consecutive days， bid， 20 mg/time， and psychological intervention was given to the patients. The degree of postoperative pain， postoperative rehabilitation index， liver coagulation recovery and psychological status of the two groups were compared. Results The numerical rating scale pain score in the observation group was lower than that in the control group at the same time after operations， with statistically significant difference(P<0.05). The postoperative rehabilitation index of the observation group was better than that of the control group， and the difference was statistically significant(P<0.05). There was no significant difference in coagulation indexes of liver function between the two groups at baseline(P>0.05). On the third day after operations， the coagulation of liver function in the observation group was better than that in the control group， with statistically significant difference(P<0.05). There was no significant difference in preoperative SAS and SDS scores between the two groups (P>0.05). The scores of the two groups decreased after operations， and the SAS and SDS scores of the observation group were lower than those of the control group， with statistically significant difference(P<0.05). Conclusion Multi-mode preventive analgesia combined with positive psychological intervention makes postoperative pain of liver cancer patients be safely and effectively controlled， promotes postoperative liver function and coagulation recovery， relieves postoperative anxiety and depression of patients， and accelerates postoperative rehabilitation process., http://www.100md.com(张一范 王巍)
[关键词] 多模式预防性镇痛;正性心理干预;肝癌;术后康复
[中图分类号] R735.7 [文献标识码] B [文章编号] 1673-9701(2020)21-0058-06
Impacts of multi-mode preventive analgesia combined with positive psychological intervention on postoperative rehabilitation of liver cancer patients
ZHANG Yifan WANG Wei
Department of General Surgery， the First Affiliated Hospital of Jinzhou Medical University， Jinzhou 121000， China
[Abstract] Objective To investigate the impacts of multi-mode preventive analgesia combined with positive psychological intervention on postoperative rehabilitation of liver cancer patients. Methods From December 2018 to December 2019， 80 patients undergoing liver cancer surgery in the First Affiliated Hospital of Jinzhou Medical University were randomly divided into the observation group and the control group. The psychological state of the patients was evaluated at baseline， and the observation group was given psychological intervention on this basis. Intraoperatively， the observation group was anesthetized with 0.25% ropivacaine 20 mL layer by layer around the incision 5-10 min before skin incision， and the depth of infiltration was from subcutaneous to peritoneal layer. The postoperative control group was treated with self-controlled intravenous analgesia pump. The observation group received an intramuscular injection of parecoxib sodium for three consecutive days， bid， 20 mg/time， and psychological intervention was given to the patients. The degree of postoperative pain， postoperative rehabilitation index， liver coagulation recovery and psychological status of the two groups were compared. Results The numerical rating scale pain score in the observation group was lower than that in the control group at the same time after operations， with statistically significant difference(P<0.05). The postoperative rehabilitation index of the observation group was better than that of the control group， and the difference was statistically significant(P<0.05). There was no significant difference in coagulation indexes of liver function between the two groups at baseline(P>0.05). On the third day after operations， the coagulation of liver function in the observation group was better than that in the control group， with statistically significant difference(P<0.05). There was no significant difference in preoperative SAS and SDS scores between the two groups (P>0.05). The scores of the two groups decreased after operations， and the SAS and SDS scores of the observation group were lower than those of the control group， with statistically significant difference(P<0.05). Conclusion Multi-mode preventive analgesia combined with positive psychological intervention makes postoperative pain of liver cancer patients be safely and effectively controlled， promotes postoperative liver function and coagulation recovery， relieves postoperative anxiety and depression of patients， and accelerates postoperative rehabilitation process., http://www.100md.com(张一范 王巍)