目的：探讨激励式心理干预对不同麻醉方式的择期手术患者术前焦虑、抑郁及心率、血压的影响。方法将2012年8月~2013年10月在河北省唐山市协和医院行择期手术的患者240例，按麻醉方式不同分为局麻组、腰硬麻组和全麻组，三组患者分别实行针对性的激励式心理干预，于心理干预前及患者入手术室后分别测定焦虑、抑郁情况及心率、血压，并进行比较。结果干预后，局麻组SAS得分[(26.6±5.4)分]、SDS得分[(22.4±6.1)分]和收缩压[(123.3±5.1)mm Hg]与干预前[(59.3±6.5)分、(45.6±3.2)分和(140.2±2.1)mm Hg]比较有明显改善，差异有统计学意义(P<0.05)；组间比较结果显示，全麻组干预后SAS得分[(34.5±1.3)分]和SDS得分[(28.6±3.5)分]均高于局麻组和腰硬麻组[(25.8±2.2)、(21.3±3.8)分]，差异有统计学意义(P<0.05)。心率方面，干预后三组心率与干预前相比，均有所降低，但干预前后比较差异均无统计学意义(P>0.05)。干预后心率及收缩压局麻组与腰硬麻组、局麻组与全麻组以及腰硬麻组与全麻组组间比较，差异均无统计学意义(P>0.05)。结论激励式心理干预能明显缓解手术患者的不良情绪，尤其是在非全身麻醉患者中效果更加明显，能稳定择期手术患者术前心理状态，保证手术及麻醉顺利进行。%Objective To explore the effect of psychological intervention on anxiety, depression and heart rate, blood pressure of selective operation patients with different anesthesia methods. Methods According to different ways of anesthesia, 240 patients who were given selective operation from August 2012 to October 2013 in Union Hospital of Tangshan City, were divided into the local anesthesia group, lumbar epidural anesthesia group and general anesthesia group. Patients in the three groups were given targeted incentive psychological intervention, then measured the anxiety and depression condition, heart rate, blood pressure, the results were compared. Results After intervention, compared the SAS [(26.6±5.4) scores], SDS [(22.4±6.1) scores] and systolic blood pressure [(123.3±5.1) mm Hg] in local anesthe-sia group with before intervention [(59.3±6.5) scores, (45.6±3.2) scores and (140.2±2.1) mm Hg], they were obviously improved, the differences were statistically significant (P< 0.05). Comparison between groups, after intervention, SAS [(34.5±1.3) scores] and SDS [(28.6±3.5) scores] in general anesthesia group were higher than those of local anesthesia group and lumbar epidural anesthesia group [(25.8±2.2), (21.3±3.8) scores], there were significant differences (P<0.05). Heart rates of the three groups after intervention were all lower than before intervention, but there was no signifi-cant difference (P>0.05). After intervention the differences of heart rate and systolic blood pressure in local anesthesia group and lumbar epidural anesthesia group, local anesthesia group and general anesthesia group, lumbar epidural anesthesia group and general anesthesia group had no statistically significant (P>0.05). Conclusion The incentive psy-chological intervention can relieve the bad emotion of patients in operation, especially in patients with non general anesthesia, which can stable patients' preoperative psychological state, ensure smooth operation and anesthesia.
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