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音乐干预对心脏手术应激反应的随机临床试验效果。

The effect of music intervention in stress response to cardiac surgery in a randomized clinical trial.

机构信息

Department of Cardiothoracic Surgery and Center for Health Care Sciences, Orebro University Hospital, PO Box 1324, Orebro SE-70113, Sweden.

出版信息

Heart Lung. 2009 May-Jun;38(3):201-7. doi: 10.1016/j.hrtlng.2008.07.008. Epub 2008 Oct 5.

Abstract

OBJECTIVE

To evaluate the effect of bed rest with music on the first postoperative day to decrease stress for patients who have undergone heart surgery.

METHODS

A repeated-measures randomized controlled trial was used. The study took place in a cardiothoracic intermediary unit of a university hospital in Sweden. Fifty-eight patients who had undergone open coronary artery bypass grafting or aortic valve replacement surgery were included. Stress response was assessed by determining the serum cortisol, heart rate, respiratory rate, mean arterial pressure, arterial oxygen tension, arterial oxygen saturation, and subjective pain and anxiety levels. At 12:00 noon on postoperative day 1, patients were allocated to receive 30 minutes of uninterrupted bed rest with music and then 30 minutes of bed rest or alternatively 60 minutes of uninterrupted bed rest. The music was soft and relaxing, included different melodies in new-age style, played with a volume at 50 to 60 dB, and distributed through a music pillow connected to an MP3 player.

RESULTS

After 30 minutes of bed rest, there was a significant difference in s-cortisol levels between the groups; 484. 4 mmol/L in the music group versus 618.8 mmol/L in the control group (P < .02). However, this difference in s-cortisol levels was not found 30 minutes later (ie, after a total of 60 minutes). There was no difference in heart rate, respiratory rate, mean arterial pressure, arterial oxygen tension, arterial oxygen saturation, and subjective pain and anxiety levels between the groups.

CONCLUSION

There is sufficient practical evidence of stress reduction to suggest that a proposed regimen of listening to music while resting in bed after open heart surgery be put into clinical use.

摘要

目的

评估术后第一天卧床听音乐对减轻心脏手术后患者压力的效果。

方法

采用重复测量随机对照试验。该研究在瑞典一所大学医院的心胸科中间病房进行。共纳入 58 例行冠状动脉旁路移植术或主动脉瓣置换术的患者。通过测定血清皮质醇、心率、呼吸频率、平均动脉压、动脉血氧分压、动脉血氧饱和度以及主观疼痛和焦虑水平来评估应激反应。术后第 1 天中午 12 点,将患者分为两组,一组接受 30 分钟不间断卧床听音乐和 30 分钟卧床休息,另一组接受 60 分钟不间断卧床休息。音乐轻柔放松,采用新世纪风格的不同旋律,音量为 50 到 60 分贝,通过与 MP3 播放器相连的音乐枕头播放。

结果

卧床 30 分钟后,两组间 s-皮质醇水平有显著差异;音乐组为 484.4mmol/L,对照组为 618.8mmol/L(P<.02)。但 30 分钟后(即总共 60 分钟后),s-皮质醇水平的差异不再存在。两组间心率、呼吸频率、平均动脉压、动脉血氧分压、动脉血氧饱和度和主观疼痛及焦虑水平均无差异。

结论

有充分的实践证据表明,听音乐可减轻压力,建议将这种开胸手术后卧床听音乐的方案应用于临床。

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