中国科学院心理研究所机构知识库

目的:观察意象对话技术(IDS)对妇科患者术前后血压(blood pressure,BP)和心率(heartrate,HR)的影响,探索减轻术前焦虑的最佳方式。方法:将188例焦虑自评量表(Self-Rating Anxiety Scale,SAS)测评得分大于50的妇科手术病人用随机数字表法分为IDS组、音乐意象放松(MIR)组及对照组。IDS组于术前1d下午给予意象对话心理干预,MIR组于同一时间给予播放自制的MIR录音干预,统计三组干预前及干预后(术前1d、术前0.5h、术后1h、术后12h～24h)的BP和HR,作为疗效评价指标。结果:两个干预组干预前后BP和HR变化均有显著差异:收缩压(systolic pressure,SBP)、舒张压(diastolic pressure,DBP)、HR各指标均明显下降(P<0.010)。干预前与术前0.5hBP和HR比较:IDS组术前HR低于干预前(t=5.734,P=0.000);MIR组术前DBP高于干预前(t=-3.265,P=0.002),术前HR低于干预前(t=2.968,P=0.004)。对照组SBP、DBP高于干预前(P=0.000)。干预前与术后1hBP和HR比较:IDS组SBP、DBP、HR术后1h均低于干预前(P=0.013,P=0.024,P=0.000);MIR组SBP、HR术后1h均低于干预前(P=0.014,P=0.000);对照组HR术后1h均低于干预前(t=5.611,P=0.000)。术后12h～24hBP和HR与干预前比较三组均有下降。结论:IDS和MIR干预对减轻手术前后的心理和生理应激有不同的作用,IDS在稳定BP和HR方面更优于MIR。

Objective： Observe what effect does imagery - dialogue skill has on the BP and HR in pre - operation and post - operation. Explore the best way to alleviate the pre- operation anxiety. Methods： 188 gynecological operation patients （with SAS scores above 50） were divided into three groups： imagery - dialogue skill （IDS） group, music - imagery - relaxation （MIR） group, and control group. IDS group was given imagery dialogue mental intervention in the afternoon of 1 day pre- operation. MIR group was given intervention of playing self - made relaxation music tape recordings at the same time. Evaluate BP and HR of 3 groups in both pre - intervention and post - intervention （1 day pre - operation,0.5 h pre - operation, 1 h post - operation, 12 h - 24 h after operation） and as index of assessing efficiency.Results： Changes of the BP and HR were significantly distinct between two intervention groups in pre and post- intervention：SBP,DBP and HR all declined apparently （ P 〈 0.010）.The comparison of BP and HR between pre - intervention and O. 5 h pre - operation： HR of the IDS group in pre - operation was lower than that in pre - intervention （t = 5. 734, P = 0. 000）; DBP of the MIR group in pre- operation was higher than that in pre- intervention （ t = -3. 265, P = 0.002） and HR in pre - operation was lower than that in pre - intervention （ t = 2.968, P = 0.004） .The SBP and DBP of control group in pre - operation were higher than that in 1 day before operation （ P = 0.000）. The comparison of BP and HR between pre -intervention and 1 h post- operation： SBP,DBP and HR of IDS group were lower in 1 h post- operation than that in pre- intervention （ P = 0.013,0.024,0.O00,respectively）. The comparison of BP and HR between pre- intervention and 1 h post- operation in MIR group： DBP and HR in 1 h post- operation were lower than that in pre- intervention （ P = 0.014, 0.000）. The comparison of BP and HR between pre - intervention and 1 h post - operation in control group ： HR were lower in l h post - operation than that in pre - intervention （ t = 5.611, P = 0.000）. The BP and HR of three groups in 12 h - 24 h after operation all declined compared to that in pre - intervention. Conclusion：lDS and MIR intervention have different effects on alleviating psychological and physiological stress of patients in pre- operation,which are still obvious in 1 h post -operation. IDS is better than MIR at stabilizing BP and HR.

长治医学院附属和平医院基金资助项目　　（0802）