世界中医药

目的：探讨心理干预结合针灸疗法对老年患者围术期血流动力学及苏醒质量的影响。方法：50例择期行膝关节置换术的老年患者(ASA，Ⅰ-Ⅱ级)随机分为心理干预结合针灸疗法组(A组，n=25)和对照组(B组，n=25)。2组患者均接受常规围术期护理，A组患者在此基础上实施围术期心理干预，术后结合针灸疗法。监测并记录2组患者在麻醉前(T1)、插管时(T2)、拔管时(T3)及术后30min(T4)的心率(Heart Rate，HR)、平均动脉压(Mean Artery Pressure，MAP)的变化及2组患者术毕至完全清醒时各项指标的时间、不良反应的发生率。结果：2组患者在T2、T3、T4与T1比较，HR和MAP均升高，2组患者在T1、T4时，组间比较有统计学意义(P<0.05)；2组患者术毕至完全清醒时的各项指标，组间相比有统计学意义(P<0.05)。2组患者术后不良反应发生率，A组患者明显低于B组患者(P<0.05)。结论：心理干预结合针灸疗法能够保证围术期血流动力学的稳定，缩短拔管的时间，降低术后不良反应的发生率。

English Summary:

To explore the psychological intervention on hemodynamics and the quality of awaking in elderly patients during perioperative period.Methods:A total of 50 patients with Knee Replacement (ASA,Ⅰ Ⅱ) were randomized into two groups: psychological intervention group (group A, n=25) and control group (group B, n=25). The two group patients received same conventional care, on top of that, group A patients also received perioperative psychological intervention. Monitored HR, MAP before induction of anesthesia(T1), intubation(T2), extubation(T3) and 30 min after operation(T4), time to wake up from operation, and adverse reaction.Results:The MAP and HR of two groups rose at T2,T3,T4 compared with T1, there were significant difference between two groups in T1 and T4 (P<0.05). Compared with group B, time to wake up from operation and incidence of adverse reaction were significantly lower in group A (P<0.05).Conclusion:The study suggested that psychological intervention can ensure hemodynamic stability, shorten extubation period significantly and reduce incidence of adverse reaction.

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