林敏 林华英 罗文芬 黄秋英 李雪慧

【摘要】 目的：分析激勵式心理干预联合加速康复外科（enhanced recovery after surgery，ERAS）在选择性剖宫产患者中的应用效果。方法：纳入2022年5—7月在暨南大学附属顺德医院接受基础护理的选择性剖宫产产妇30例作为对照组，2022年8—10月接受ERAS护理的选择性剖宫产产妇30例作为ERAS组，2022年11月—2023年1月接受激励式心理干预的选择性剖宫产产妇30例作为心理干预组，2023年2—4月接受激励式心理和ERAS联合干预的选择性剖宫产产妇30例作为联合组。对比经护理干预后四组的围手术期临床指标、负性情绪指标、术后疼痛评分和并发症。结果：联合组的肠鸣音恢复时间、排便时间和离床时间及术后泌乳时间均明显早于对照组、ERAS组和心理干预组（P<0.05）。分娩后焦虑自评量表（SAS）和抑郁自评量表（SDS）评分及术后2、12 h的疼痛评分均明显低于对照组、ERAS组和心理干预组（P<0.05）。四组围手术期并发症总发生率对比，差异无统计学意义（P>0.05）。结论：激励式心理干预联合EARS护理选择性剖宫产患者，可减轻术后疼痛，调节负面情绪，促进其早日康复。

【关键词】 激励式心理 加速康复外科 选择性剖宫产

Application Effect of Incentive Psychological Intervention Combined with Enhanced Recovery after Surgery in Patients with Selective Cesarean Section/LIN Min， LIN Huaying， LUO Wenfen， HUANG Qiuying， LI Xuehui. //Medical Innovation of China， 2024， 21（08）： -160

[Abstract] Objective： To analyze the application effect of incentive psychological intervention combined with enhanced recovery after surgery （ERAS） in patients with selective cesarean section. Method： A total of thirty women with selective cesarean section who received basic care in the Affiliated Shunde Hospital of Jinan University from May to July 2022 were included as the control group， and 30 women with selective cesarean section who received ERAS care from August to October 2022 were included as ERAS group， thirty women with selective cesarean section who received incentive psychological intervention from November 2022 to January 2023 were included in the psychological intervention group， and 30 women with selective cesarean section who received incentive psychological intervention and ERAS combined intervention from February to April 2023 were included in the combined group. The perioperative clinical indexes， negative emotional indexes， postoperative pain scores and complications of four groups after nursing intervention were compared. Result： The intestinal sound recovery time， defecation time， time to leave bed and postoperative lactation time in combination group were significantly earlier than those in control group， ERAS group and psychological intervention group （P<0.05）. The self rating anxiety scale （SAS） and self-rating depression scale （SDS） scores at and delivery， as well as pain scores at 2， 12 h

after surgery were significantly lower than those in control group， ERAS group and psychological intervention group （P<0.05）. There was no statistically significant difference in the total incidence of perioperative complications among four groups （P>0.05）. Conclusion： Incentive psychological intervention combined with EARS care for patients with selective cesarean section can alleviate postoperative pain， regulate negative emotions， and promote their early recovery.

[Key words] Incentive psychological Enhanced recovery after surgery Selective cesarean section

First-author's address： Department of Obstetrics， the Affiliated Shunde Hospital of Jinan University， Foshan 528305， China

doi：10.3969/j.issn.1674-4985.2024.08.035

选择性剖宫产尽管有镇痛技术的支持，可大幅度降低患者疼痛，但其并不能完全消减疼痛，在术后患者依旧存在较为明显的疼痛感受，加之患者心理压力大，对手术相关了解较少，以及缺乏分娩经验等影响，可导致其在围手术期合并较为严重的负面心理、疼痛和不适感受，会对手术效果及术后恢复带来不利影响[1-2]。加速康复外科（ERAS），可加速患者康复进程，减少并发症风险，但因人力资源的短缺，临床实施存在着一定的问题，如侧重生理护理，而未对患者的心理状态采取全方位的深入干涉[3-4]。……