手术室环境对人工股骨头置换术患者等待期应激反应的影响

来源期刊：广州医药 | 1275-1281 发布时间：2024-12-02 收稿时间：2025/11/13 18:43:06 阅读量：19

作者：: 冯颖超,

高萍,

邓倩,

张毅,

李荃,

关键词：: 手术室环境人工股骨头置换术等待期应激反应; operating room environment artificial femoral head replacement stress response during the waiting period

DOI：: 10.20223/j.cnki.1000-8535.2024.11.006

收稿时间：: 2024-03-12
修订日期：
接收日期：
引用总数：: 0

目的探讨手术室环境对人工股骨头置换术患者等待期应激反应的影响。方法回顾性选取2021年1月1日—2023年7月31日入院的84例患者,患者均需要接受人工股骨头置换术治疗。根据患者接受治疗时手术室的环境将患者分为两组,对照组42例患者,其接受手术治疗时手术室环境未改造升级;观察组42例患者,其接受手术治疗时手术室环境已改造升级。对比两组应激反应（肾上腺素、皮质醇水平）、情绪状态[汉密尔顿抑郁量表（HAMD）评分、汉密尔顿焦虑量表（HAMA）评分]、血压（收缩压、舒张压、心率）、生活质量评分、患者对手术室环境的满意度。结果 T₁时刻,两组肾上腺素、皮质醇水平均升高,但对照组升高幅度[（43.48±4.59）pg/L、（268.48±13.55）ng/L]大于观察组[（38.15±5.28）pg/L、（240.15±12.48）ng/L],对比差异有统计学意义（t=4.937、9.967,P<0.05）。T₁时刻,两组HAMD、HAMA评分均升高,对照组水平[（22.84±3.26）（24.03±3.47）分]大于观察组[（19.75±3.73）（20.76±3.36）分],对比差异有统计学意义（t=4.042、4.387,P<0.05）。T₁时刻,两组收缩压、舒张压、心率水平均显著升高,但对照组升高幅度[（129.34±7.25）mmHg、（94.25±6.62）mmHg、（88.58±3.27）次/分]大于观察组[（117.62±8.13）mmHg、（85.63±5.38）mmHg、（82.16±3.66）次/分],对比有统计学意义（t=6.973、6.549,8.477,P<0.05）。术后5 d,两组各维度评分均显著升高,观察组各维度评分高于对照组（P<0.05）。观察组患者对手术室环境的满意率高于对照组（97.62% vs 85.71%,χ²=3.896,P=0.048）。结论手术室环境改造升级对人工股骨头置换术患者具有积极作用,可有效降低患者等待期应激反应,减轻患者等待期焦虑、抑郁情绪,降低患者等待期血压、心率上升幅度,有利于提升患者术后生活质量,提高患者对手术室环境的满意度。

Objective To investigate the effect of operating room environment on stress response during the waiting period in patients with artificial femoral head replacement．Methods Eighty-four patients admitted between January 1,2021 to July 31,2023 required artificial femoral head replacement．According to the operating room environment during treatment,the patients were divided into two groups．Forty-two patients in the control group received the surgical treatment in the original operating room environment and 42 patients received surgical treatment in upgraded environment．Comparing two groups of stress response（adrenaline,cortisol）,emotional status[HAMD score,HAMA score],blood pressure（systolic blood pressure,diastolic blood pressure,heart rate）,quality of life,patient satisfaction with the operating room environment of two groups were compared．Results At time T₁,epinephrine and cortisol levels were significantly increased in the two groups,but the control group increased[（43.48±4.59）pg/L,（268.48±13.55）ng/L] greater than the observation group[（38.15±5.28）pg/L,（240.15±12.48）ng/L],which were statistically significant（t=4.937,9.967,P<0.05）．At time T₁,the HAMD and HAMA scores were significantly higher in both groups,but the increase[（22.84±3.26）and（24.03±3.47）] was greater than the observation group[（19.75±3.73）and（20.76±3.36）],which showed statistical significance（t=4.042,4.387,P<0.05）． At time T₁,SBP,DBP and heart rate increased significantly in both groups,but the control group increased[（129.34±7.25）mmHg,（94.25±6.62）mmHg,（88.58±3.27）][（117.62±8.13）mmHg,（85.63±5.38）mmHg,（82.16±3.66）/min] grater than the observation group（t=6.973,6.549,8.477,P<0.05）．Five days after surgery,the scores of each dimension increased significantly in both groups,but the observation group increased more than the control group（P<0.05）．The observation group patients showed a higher satisfaction rate of the operating room environment than the control group（97.62% vs 85.71%,χ²=3.896,P=0.048）．Conclusion sThe transformation and upgrading of the operating room environment has a positive effect on the patients with artificial femoral head replacement,which can effectively reduce the stress response of patients during the waiting period,reduce the anxiety and depression of patients during the waiting period,and reduce the rise in blood pressure and heart rate of patients during the waiting period,which is conducive to improving the quality of life of patients after surgery and improving the satisfaction of patients with the operating room environment．

1、沈洋,石燕,耿伟,等.手术室规范化流程管理在俯卧位胸腰椎骨折全身麻醉术中的应用效果[J].河北医药,2023,45(23):3664-3666,3670.

2、张泽昊,杨敏利,冯园园,等.4R危机管理理论联合分级管理模式在手术室管理中的应用及对舒适度、不良事件发生的影响[J].中国医药导报,2023,20(8):171-175.

3、陈怡洁. 手术室全期细节护理对手术室患者护理质量及满意度的影响[J].智慧健康,2022,8(13):161-163.

4、管恩玲,陈淑萍,何敏芝.质量控制小组管理法在手术室护理管理中的应用效果观察[J].中国医刊,2020,55(5):572-574.

5、赖喜红,刘娟,刘贤英,等.手术室整体护理对高龄腹腔镜手术患者心理状态及生活质量的影响[J].基层医学论坛,2021,25(27):3855-3857.

6、蔡颖超,吴芬,吴红霞,等.精细化护理应用于胸腔镜下肺癌根治术手术室护理中的效果观察及评价[J].中国药物与临床,2019,19(14):2495-2497.

7、吕晓敏,景彩娥,李园园.手术室护理管理中质量控制模式的应用及对护理质量的影响[J].中国社会医学杂志,2020,37(4):442-445.

8、韩强,乔超.手术室循环评分系统在护理质量管理中的效果观察[J].河北医药,2022,44(14):2235-2237.

9、姚岚,郭菲.手术室护理干预对甲状腺手术患者应激反应及心理状态的影响[J].长春中医药大学学报,2020,36(6):1294-1296.

10、 HUANG X,WU H.Effect of predictive nursing combined with emotional therapy on rehabilitation effect and psychological state of patients with brain injury after the operation[J].Appl Bionics Biomech,2022(2022):4159085.

11、 CHI R B,CAI Y Y,MAO H P.Intervention effect of encouraging mental and programmed nursing of patients in interventional operating room on their compliance and bad moods[J].World J Clin Cases,2022,10(21):7285-7292.

12、陈茹,张珏琼,沈中鸣,等.人工全膝关节置换术患者手术等待期焦虑水平的调查分析[J].中西医结合护理(中英文),2019,5(2):105-107.

13、陈丹,张婷.手术室心理护理对宫颈癌患者术前应激反应及疗效的影响[J].中国肿瘤临床与康复,2019,26(2):238-241.

14、钟金兰. 细节化手术室护理干预对腹部手术患者预防切口感染及应激反应的影响[J].山西医药杂志,2021,50(20):2967-2969.

15、吕丽霞,肖将娣,陈美.多学科整合护理路径联合手术室优质护理对下肢骨折的应用效果及对术后下肢静脉血栓影响[J].广州医药,2024,55(2):186-191.

16、孙利,赵瑜.手术室护理干预对肿瘤手术患者应激反应的影响[J].中国肿瘤临床与康复,2019,26(1):105-108.

17、蒋新艳,来伟,章晓玲,等.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[J].护理学报,2023,30(14):65-69.

18、徐学玲,殷文会.基于快速康复理念下的针对性护理对老年髋关节置换术患者手术应激术后恢复及近期并发症的影响[J].山西医药杂志,2022,51(3):341-344.

19、彭毅,王福刚,丁庆民.腰椎旁神经阻滞联合全凭静脉麻醉对髋关节置换术患者血流动力学、应激反应、术后苏醒的影响[J].河北医科大学学报,2021,42(4):461-465.

20、徐水英,赵丽娜,杨跃.基于视觉传达理论的照顾者思维导图教育在宫颈环扎手术患者中的应用[J].广州医药,2023,54(2):55-60.

21、肖美慧,王琴,刘傥,等.奥塔戈运动对老年股骨颈骨折髋关节置换术患者肢体功能恢复的效果[J].中南大学学报(医学版),2022,47(9):1244-1252.

22、葛伟伟,蔡璐,颜小挺.加速康复外科理念在髋关节置换术围术期护理中的应用效果观察[J].中国药物与临床,2020,20(4):689-691.

23、 WANG S F,JI Q H,QIAO X F,et al.Efficacy of artificial femoral head replacement for femoral head avascular necrosis[J].Medicine(Baltimore),2019,98(17):e15411.

24、 O’CONNOR J D,HILL J C,BEVERLAND D E,et al.Influence of preoperative femoral orientation on radiographic measures of femoral head height in total hip replacement[J].Clin Biomech(Bristol,Avon),2021(81):105247.

25、张阳,武玉欣,曲波,等.SF-36量表在医学生生命质量评价中的应用[J].中国卫生统计,2013,30(3):468.

26、段泉泉,胜利.焦虑及抑郁自评量表的临床效度[J].中国心理卫生杂志,2012,26(9):676-679.

27、 NIE C,CHEN X,WANG L,et al.The effect of seamless nursing combined with Roy adaptive psychological nursing on self-efficacy and bad mood of patients after acute abdomen surgery[J].Medicine(Baltimore),2023,102(5):e32720.

28、胡洁晶,余婉鹏,陈蔚煊,等.前馈控制应用于股骨头坏死髋关节置换术后护理的效果[J].国际护理学杂志,2022,41(10):1836-1839.