摘要

目的：探讨腹腔镜下胆囊切除手术患者在围手术期积极开展心理护理干预改善焦虑抑郁状态及治疗依从性的作用。

方法：选取腹腔镜下胆囊切除手术患者100例，均为我院普外科2018年3月至2019年3月收治，应用数字表抽取法随机分组，就常规围手术期护理（对照组，n=50）与围手术期重视心理护理干预的实施（观察组n=50）胃肠功能恢复指标、疼痛程度、焦虑抑郁状态、自我效能感、治疗依从性、并发症率展开对比。

结果：观察组患者术后肠鸣音恢复时间、肛门首次排气时间、排便时间经观察均少于对照组，差异具有统计学意义（P<0.05）；两组术后6h疼痛评分无差异（P>0.05），术后24h、48h、72h不同时点评分均有降低，且观察组降低程度较对照组更为显著（P<0.05）；两组干预前，焦虑、抑郁心理状态评分经评测无差异（P>0.05）；干预后评测分值较前均有程度不等下降，但观察组下降程度较对照组更为显著（P<0.05）；两组干预前，自我效能感评分无差异（P>0.05），干预后评分较前均有升高，但观察组升高程度较对照组更为显著（P<0.05）；观察组干预后治疗依从性各维度即遵守院内制度、积极乐观、合理饮食、适宜锻炼比例均高于对照组（P<0.05）；观察组术后并发症率低于对照组（P<0.05）。

结论：腹腔镜下胆囊切除手术患者在围手术期积极开展心理护理干预，可促进胃肠功能恢复，缓解疼痛，改善焦虑抑郁状态，提高自我效能感及治疗依从，且具更高安全性，具非常重要的开展价值。

关键词：腹腔镜下胆囊切除手术；心理护理；术后恢复指标；焦虑抑郁状态；治疗依从性

ABSTRACT

Objective: To explore the effect of psychological nursing intervention on anxiety and depression and treatment compliance of patients undergoing laparoscopic cholecystectomy during perioperative period.

Methods: 100 patients undergoing laparoscopic cholecystectomy were selected and treated in our general surgery department from March 2018 to March 2019. The patients were randomly divided into two groups by using digital table extraction method. The indexes of gastrointestinal function recovery, pain degree, anxiety and depression state, and self-efficacy were compared between the routine perioperative nursing (control group, n=50) and the implementation of psychological nursing intervention (observation group n=50). Compliance of treatment and complication rate were compared. Result: The recovery time of bowel sounds, the first exhaust time of anus and defecation time after operation in the observation group were less than those in the control group, and the difference was statistically significant (P < 0.05); there was no difference in pain score at 6 hours after operation between the two groups (P > 0.05), and the scores at different time points at 24 hours, 48 hours and 72 hours after operation were all decreased, and the reduction degree in the observation group was more significant than that in the control group (P < 0.05). The scores of anxiety and depression had no difference (P > 0.05); after intervention, the scores of evaluation decreased to some extent, but the degree of decline in the observation group was more significant than that in the control group (P < 0.05); before intervention, the scores of self-efficacy had no difference between the two groups (P > 0.05); after intervention, the scores of self-efficacy increased, but the increase in the observation group was more significant than that in the control group (P < 0.05). The treatment compliance of the observation group was higher than that of the control group (P < 0.05), and the complication rate of the observation group was lower than that of the control group (P < 0.05).

Conclusion  : Positive psychological nursing intervention in perioperative period for patients undergoing laparoscopic cholecystectomy can promote the recovery of gastrointestinal function, alleviate pain, improve anxiety and depression, improve self-efficacy and treatment compliance, and has a higher safety, which has very important development value.

Key words: Laparoscopic cholecystectomy; Psychological nursing; Postoperative recovery indicators; Anxiety and depression; Treatment compliance