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目的探索基于加速康复外科(enhanced recovery after surgery,ERAS)的脊髓型颈椎病患者围手术期心理管理流程在该类患者围手术期心理管理中的应用效果。方法将2016年9月—2017年1月就诊的脊髓型颈椎病患者60例按随机数字表法随机分入试验组和对照组,每组各30例。对照组采取常规心理护理措施,试验组给予基于ERAS的围手术期心理管理流程;比较干预前后两组患者的情绪障碍情况和术后心理相关并发症发生率。结果干预前,两组患者情绪障碍比较,差异无统计学意义(Z=–0.26,P=0.792);干预后,两组患者情绪障碍比较,差异有统计学意义(Z=–2.68,P=0.007)。干预前后,对照组组内情绪障碍情况比较,差异无统计学意义(Z=–1.15,P=0.252);试验组组内情绪障碍情况比较,差异有统计学意义(Z=–4.33,P<0.001)。试验组术后心理相关并发症的发生率[3%(1/30)]低于对照组[23%(7/30)],差异有统计学意义(χ2=5.192,P=0.026)。结论对脊髓型颈椎病患者实施基于ERAS的围手术期心理管理流程,有利于缓解患者的围手术期情绪障碍,可减少术后心理相关的并发症发生。
Objective To explore the application of perioperative psychological management of patients with cervical spondylotic myelopathy due to enhanced recovery after surgery (ERAS) in the perioperative psychological management of these patients. Methods Sixty patients with cervical spondylotic myelopathy from September 2016 to January 2017 were randomly divided into experimental group and control group according to random number table method, with 30 cases in each group. The control group took the conventional psychological care measures, and the experimental group was given the perioperative psychological management process based on ERAS. The emotional disturbance and postoperative psychology-related complication rates were compared between the two groups before and after the intervention. Results Before intervention, there was no significant difference in emotion disorder between the two groups (Z = -0.26, P = 0.792). After the intervention, there was significant difference in emotion disorder between the two groups (Z = -2.68, P = 0.007). Before and after the intervention, there was no significant difference in emotion disorder among the control group (Z = -1.15, P = 0.252). There was significant difference in emotion disorder among the experimental group (Z = -4.33, P < 0.001). The incidence of postoperative psychological-related complications in the experimental group (3% (1/30)) was lower than that in the control group (23%, 7/30). The difference was statistically significant (χ2 = 5.192, P = 0.026). Conclusion Perioperative psychological management of patients with cervical spondylotic myelopathy based on ERAS is conducive to the relief of perioperative mood disorders in patients with postoperative psychiatric related complications can be reduced.