吴利和 余晓 徐慧 汪美君

[摘要] 目的 探讨冰冻切片等待期心理干预对妇科肿瘤患者术中应激反应的影响。 方法 随机选取2011年间100例行妇科肿瘤手术患者，术中冰冻切片等待期对其进行综合心理干预，分别于入室后麻醉前及肿瘤切除送冰冻30 min后（冰冻结果报告前）测定其生命体征和血糖、皮质醇、肾上腺素等应激激素数值进行对比分析。 结果 冰冻切片等待期经心理干预后患者的心率、收缩压、舒张压、呼吸等数值均显著低于麻醉前，差异具有统计学意义（P < 0.01）；血糖、皮质醇、肾上腺素等数值差异无统计学意义（P > 0.05）。 结论 冰冻切片等待期心理干预可有效降低术中应激反应的强度，应引起临床护理工作的高度关注。

[关键词] 冰冻切片；等待期；心理干预；应激反应

[中图分类号] R473.6[文献标识码] B[文章编号] 1673—9701（2012）25—0110—02

The effect of psychological intervention in frozen sliced waiting period on stress reaction in patients with gynecologic oncology

WU Lihe YU Xiao XU Hui WANG Meijun

Operating Room，the Affiliated Quzhou Central Hospital of Zhejiang Chinese Medical University，Quzhou 324000，China

[Abstract] Objective To discuss the effect of psychological intervention in frozen sliced waiting period on stress reaction in patients with gynecologic oncology. Methods We randomly selected 100 cases of patients with gynecologic oncology surgery in 2011，and for them a comprehensive psychological intervention in frozen sliced waiting period. The patient's vital signs and blood glucose，cortisol， epinephrine were measured before anesthesia and after send tumor 30 min（before the pathological diagnosis report），and these data were compared. Results After psychological intervention in frozen sliced waiting period，the patient's heart rate，systolic blood pressure，diastolic blood pressure，breathing were significantly lower than the before anesthesia，the difference was significant （P < 0.01）；however，there was no significant difference in blood glucose，cortisol，epinephrine（P > 0.05）. Conclusion Psychological intervention in frozen sliced waiting period can effectively reduce the intensity of the stress response，and should cause great concern of the clinical care.

[Key words] Frozen slice；Waiting period；Psychological intervention；Stress response

手术作为一种应激源，能使患者产生较强烈的应激反应，出现紧张、恐惧等心理，从而引起生命体征及情绪的变化，甚至影响麻醉和手术的正常进行[1]。尤其在术中冰冻切片病理结果等待期间，患者对肿瘤性质良性结果的期望以及对恶性结果的恐惧几乎达到了顶峰，一直处于强烈应激状态，心理压力极其巨大，极易产生不良后果从而影响整体治疗效果[2]。近年来，我们在患者冰冻切片结果等待期间对其进行心理干预治疗，有效降低患者应激反应的强度，现报道如下。

1 资料与方法

1.1 一般资料

随机选取2011年1～12月间在我院住院手术的妇科肿瘤病人100例进行观察研究，所有患者除常规围术期护理干预外，术中冰冻切片等待期进行包括语言交流、肢体接触、背景音乐等多种方法、全方位的综合心理干预[3]。……