以质量求发展,以服务铸品牌

护理学报 ›› 2023, Vol. 30 ›› Issue (14): 65-69.doi: 10.16460/j.issn1008-9969.2023.14.065

• 临床护理※手术室护理 • 上一篇    下一篇

手术室环境对膝关节镜检查术患者等待期应激反应的影响

蒋新艳a, 来伟b, 章晓玲a, 蒋玉婷a, 邓飞娜c   

  1. 中国人民解放军联勤保障部队第908医院 a.手术室; b.麻醉科; c.感控科,江西 南昌 332000
  • 收稿日期:2023-03-06 出版日期:2023-07-25 发布日期:2023-08-04
  • 通讯作者: 章晓玲(1966-),女,江西南昌人,本科学历,副主任护师,护士长。E-mail:3556357670@qq.com
  • 作者简介:蒋新艳(1977-),女,江西九江人,本科学历,主管护师。
  • 基金资助:
    2022年度江西省卫生健康委科技计划项目(202211370)

Influence of operating room environment on stress response during waiting period in patients undergoing knee arthroscopy

JIANG Xin-yana, LAI Weib, ZHANG Xiao-linga, JIANG Yu-tinga, DENG Fei-nac   

  1. a.Operating Room; b. Dept. of Anesthesia; c. Dept. of Infection Control,No. 908 Hospital of PLA Joint Logistic Support Force, Nanchang 332000, China
  • Received:2023-03-06 Online:2023-07-25 Published:2023-08-04

摘要: 目的 探讨不同手术室环境对膝关节镜检查术等待期患者焦虑情绪、血清皮质醇、促肾上腺皮质激素水平和血压、心率的影响。方法 选取2021年6月—2022年5月在本院进行择期单侧膝关节镜检查术患者109例,按就诊时间顺序将手术室环境改造升级前手术的53例设为对照组,改造升级后56例设为研究组。观察2组患者在术前访视日(T0)和入手术室后即刻(T2)的焦虑自评和血清皮质醇、促肾上腺皮质激素水平;监测患者术前访视日(T0)、术晨在病房(T1)、入手术室后即刻(T2)和麻醉前(T3)的血压、心率。结果 2组患者焦虑评分、血清皮质醇和促肾上腺皮质激素水平比较,差异有统计学意义(P<0.05);时间点与组间交互效应显著(P<0.05);简单效应分析:T0比较差异均无统计学意义,T2均有统计学意义(P<0.05);随着时间推移,2组患者焦虑评分、血清皮质醇和促肾上腺皮质激素水平呈上升趋势,两两比较结果显示,T2研究组均低于对照组,差异有统计学意义(P<0.05)。2组患者血压比较,差异有统计学意义(P<0.05);时间点与组间交互效应显著(P<0.001);简单效应分析:T0、 T1、T2 2组血压比较,差异无统计学意义(P>0.05),T3 2组血压比较,差异有统计学意义(P<0.05);随着时间推移,2组患者血压呈上升趋势,两两比较结果显示,T3研究组均低于对照组,差异有统计学意义(P<0.05)。2组患者心率比较,差异有统计学意义(P<0.05);时点与组间交互效应显著(P<0.001);简单效应分析:T0和 T1 2组心率比较,差异无统计学意义(P>0.05),T2和T3 2组心率比较,差异有统计学意义(P<0.05);随着时间推移,2组患者心率呈上升趋势,两两比较结果显示,T2和T3研究组均低于对照组,差异有统计学意义(P<0.05)。结论 改造升级后的手术室环境能有效平复膝关节镜检查术患者等待期焦虑情绪,减轻手术应激反应,稳定血压及心率。

关键词: 手术室环境, 膝关节镜检查术, 焦虑, 应激反应

Abstract: Objective To explore the influence of different operating room environment on anxiety, serum corticosterone, adrenocorticotro, blood pressure, and heart rate of perioperative patients during waiting period when undergoing knee arthroscopy. Methods One hundred and nine patients undergoing elective knee arthroscopy in our hospital from June 2021 to May 2022 were divided into control group (n=53) and study group (n=56) according to the visiting time. Self-rated anxiety and serum cortisol and corticotropin level in both groups on the preoperative visit day (T0) and right after entering the operating room (T2) were observed; blood pressure and heart rate on the preoperative visit day (T0), the morning of the operation in the ward (T1), right after entering the operation room (T2) and before anesthesia (T3) were monitored. Results There was statistically significance in terms of anxiety score, serum cortisol, and adrenocorticotropin level between the two groups (P<0.05). The interaction effect between time points and groups was significant (P<0.05). Further simple effect analysis showed that there was no statistically significance at T0, but the difference was significant at T2 (P<0.05). As time passed, there was an upward trend in anxiety score, serum cortisol, and adrenocorticotropin level. Pairwise comparison showed that anxiety score, serum cortisol, and adrenocorticotropin level in the study group was lower than those in the control group, showing statistical significance (P<0.05). The difference in blood pressure between the two groups was statistically significant (P<0.05). The interaction effect between time points and groups was significant (P<0.001). Further simple effect analysis showed that there was no statistically significant difference in blood pressure in the two groups at T0 and T1 and T2 (P>0.05), but it showed difference at T3 in the two groups (P<0.05). As time passed, there was an upward trend in blood pressure, and pairwise comparison showed that blood pressure at T3 in the study group was lower than that in the control group, showing statistical significance (P<0.05). The difference in heart rate between the two groups was statistically significant (P<0.05). The interaction effect between time points and groups was significant (P<0.001). Further simple effect analysis showed that there was no statistical difference in heart rate between the two groups at T0 and T1 (P>0.05), but the difference between the two groups at T2 and T3 was statistically significant (P<0.05). As time passed, there was an upward trend, and pairwise comparison showed that heart rate in the study group at T2 and T3 was lower than that in the control group, showing statistical significance (P<0.05). Conclusion The upgraded operating room can effectively alleviate the anxiety, reduce surgical stress reactions, and stabilize blood pressure and heart rate of patients undergoing knee arthroscopy during the waiting period.

Key words: operating room environment, arthroscopy of knee, anxiety, stress response

中图分类号: 

  • R47
[1] Rashid A, Riaz MN.Impact of preoperative surgical anxiety on postoperative surgical recovery among surgical patients: role of surgical coping[J]. J Pak Med Assoc, 2021, 71(10):e2313-2316.DOI:10.47391/JPMA.07-787.
[2] Aliche Joseph Chinenye,Ifeagwazi Chuka Mike,Eze John E.Emotional reactivity and surgical anxiety. The protective nature of perceived social support[J].Psychol Health Med, 2020,25(4):e434-445.DOI:10.1080/13548506.2019.1668030.
[3] 刘祎,曾月,李艺正,等.慢性应激促进肿瘤发展的机制及干预方式[J].中南大学学报(医学版),2022,47(9):1281-1288.DOI:10.11817/j.issn.1672-7347.2022.210589.
[4] Chen Yun Yun K, Soens Mieke A,Kovacheva Vesela P,et al.Less stress, better success: a scoping review on the effects of anxiety on anesthetic and analgesic consumption[J]. J Anesth, 2022, 36(4):e532-553.DOI:10.1007/S00540-022-03081-4.
[5] 张春明,晨晨,王家,等.焦虑量表在老年患者关节置换术中的应用[J].解放军预防医学杂志,2019,37(2):147-148.DOI:10.13704/j.cnki.jyyx.2019.02.055.
[6] Ali A,Lindstrand A,Sundberg M,et al.Preoperative anxiety and depression correlate with dissa isfaction after total knee arthroplasty:a prospective longitudinal cohort study of 186 patients,with 4-year follow-up[J]. J Arthroplasty,2017,32(3):e767-770.DOI:10.1016/j.arth.2016.08.033.
[7] 住房和城乡建设部, 国家质量监测检验检疫总局 GB 50333-2013 医院洁净手术部建设技术规范[M] GB 50333-2013 医院洁净手术部建设技术规范[M].北京:中国建筑工业出版社,2013.
[8] 环境保护部,国家质量监督检验检疫总局GB 3096-2008声环境质量标准[S]国家质量监督检验检疫总局GB 3096-2008声环境质量标准[S].北京:中国环境科学出版社,2008.
[9] 赵丽宁,李君轶.疫情期间居住环境对城市居民焦虑情绪的影响[J].浙江大学学报(理学版),2021,48(5):642-650.DOI:10.3785/j.issn.1008-9497.2021.05.015.
[10] 鞠洪杰,刘卫,王杰.住院患者尊严影响因素的研究进展[J].护理学报, 2023, 30(2):44-47.DOI:10.16460/j.issn1008-9969.2023.02.044.
[11] 王曾妍,高兴莲,崔宇杨,等.常态化疫情防控时期手术室感染防控四级督导体系的建立与实践[J].护理学报,2022,29(8):27-30.DOI:10.16460/j.issn1008-9969.2022.08.027.
[12] Kanamori H, Rutala WA, Gergen MF, et al. Perioperative bacterial contamination from patients on contact precaution in operating room environment[J]. Open Forum Infectious Diseases,2020,7(11):ofaa508.DOI:10.1093/ofid/ofaa508.
[13] 刘从会,王梓名. 人脸识别技术在医院门禁系统中的应用[J].无线互联科技,2020,17(10):154-155.
[14] 周苗,李育玲.骨科手术患者术前焦虑现状及影响因素分析[J].中华现代护理杂志,2020(5):617-622.DOI:10.3760/cma.j.issn.1674-2907.2020.05.012.
[15] 余志豪,李海波,鲜培林.大型三甲医院层流净化手术室质量控制实践[J].中国设备工程,2022(15):227-228.
[16] 郭莉. 手术室护理实践指南[M].北京:人民卫生出版社,2021:131-132.
[17] 班淇超,陈志远,陈冰,等.基于循证设计信息管理技术的医疗建筑健康性能优化[J].中国医院管理. 2019, 39(12)81-84.
[18] 郑思琪,陈璐,马晴,等.双耳节拍音乐疗法对脑卒中偏瘫患者焦虑抑郁及疲劳的效果研究[J].护理学报,2023,30(5):72-78.DOI:10.16460/j.issn1008-9969.2023.05.072.
[1] 李疆伟, 王树君, 李长仔, 胡宝山, 焦桂梅, 张卫红. 基于压力应对理论的护理干预对结直肠癌术后永久性肠造口患者心理压力、负性情绪及自我管理的影响[J]. 护理学报, 2025, 32(4): 64-69.
[2] 祁丽萍, 王文煊, 侯敏, 郑粤豪, 冯惠霞, 李济宾. 首诊鼻咽癌患者焦虑抑郁现状及其与恐惧疾病进展的关系[J]. 护理学报, 2024, 31(20): 67-72.
[3] 王柳月, 李君丽, 黄春兰, 刘芳印. 住院患者PICC置管后恐动症发生现状及影响因素分析[J]. 护理学报, 2023, 30(5): 23-27.
[4] 郑思琪, 陈璐, 马晴, 王钰涵, 成杰, 王云龙. 双耳节拍音乐疗法对脑卒中偏瘫患者焦虑抑郁及疲劳的效果研究[J]. 护理学报, 2023, 30(5): 72-78.
[5] 张鹏博, 梅永霞, 张振香, 林蓓蕾, 薛利红, 刘志薇. 脑卒中患者焦虑症状潜在剖面影响因素分析[J]. 护理学报, 2023, 30(23): 12-17.
[6] 蒋新艳, 孟海兵, 邓飞娜, 蒋玉婷, 章晓玲. 多元化环境干预对学龄前阻塞性睡眠呼吸暂停综合征患儿术前焦虑及麻醉诱导依从性的影响[J]. 护理学报, 2023, 30(20): 68-71.
[7] 夏青, 肖凤凤, 彭心雨, 游雅菲, 周婷格, 王冬华. 自主性感知在农村老年人死亡焦虑和自我养老能力间的中介作用[J]. 护理学报, 2022, 29(9): 52-57.
[8] 余小燕, 刘于, 黄毅. 小丑照护对患儿焦虑疼痛干预效果的Meta分析[J]. 护理学报, 2022, 29(4): 21-26.
[9] 左倩倩, 曾文捷, 廖敏怡, 李景秋, 罗岚, 高钰琳. 199名安宁疗护护士职业悲伤现状及影响因素分析[J]. 护理学报, 2022, 29(4): 46-52.
[10] 徐帆, 张继权, 谢绍菊, 刘洁. 积极应对在女性乳腺癌幸存者心理一致感与创伤后应激反应间的中介效应[J]. 护理学报, 2022, 29(21): 55-60.
[11] 孙娟, 李岩, 郑蔚, 王丹丹, 杨展. 基于时机理论的赋能教育在PCI手术患者中的应用[J]. 护理学报, 2022, 29(2): 74-78.
[12] 杨娇娇, 彭丽丽, 王三香, 李翊澜, 石奥利, 田甜, 杨金花. 模拟社会生活照护对养老机构老年痴呆患者激越行为的影响[J]. 护理学报, 2022, 29(17): 75-78.
[13] 蒋维, 罗玲, 张运芝, 张函, 王晓昊, 李静. 基于心理复原模型的动机性访谈对原发性肝癌患者创伤后成长的影响[J]. 护理学报, 2022, 29(10): 19-24.
[14] 周静, 毛嘉钰, 丁倍, 郑惠, 王君婧. 多维状态无聊在本科护生社交网络中的社会比较与错失焦虑间的中介效应[J]. 护理学报, 2021, 28(6): 43-47.
[15] 李爱军, 姚淳, 邝春燕, 谭行华, 林路平. 耳穴压豆联合八段锦对新型冠状病毒肺炎康复期患者焦虑抑郁的影响[J]. 护理学报, 2021, 28(6): 48-52.
Viewed
Full text


Abstract

Cited

  Shared   
No Suggested Reading articles found!