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一项关于心理行为干预联合非苯二氮䓬类药物改善膝关节置换术患者围手术期睡眠质量的随机对照研究。

A randomized controlled study of a psycho-behavioral intervention combined with a non-benzodiazepine to improve perioperative sleep quality in patients undergoing knee arthroplasty.

作者信息

Jing Wang, Chunlin Zhao, Xue Yang, Tingting He, Linyan Yuan, Xiao Chen, Lingli Li

机构信息

West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.

出版信息

Front Surg. 2023 Jul 14;10:1113577. doi: 10.3389/fsurg.2023.1113577. eCollection 2023.

Abstract

OBJECTIVE

To clarify the effectiveness and safety of psycho-behavioral intervention combined with a non-benzodiazepine to improve perioperative sleep quality in patients undergoing knee arthroplasty, and also to explore the optimal dosage of non-benzodiazepine (oral zolpidem tartrate) to form a standardized sleep quality management process to promote accelerated recovery of patients.

METHODS

240 patients undergoing initial unilateral total knee arthroplasty between January and December 2016 were prospectively included and randomly divided into blank control group (group A), psycho-behavioral intervention group (group B), zolpidem tartrate 10 mg group (group C), and psycho-behavioral intervention + zolpidem tartrate 5 mg group (group D). Sleep, pain, psychological, and knee function scores were compared.

RESULTS

There were significant differences between the four groups with respect to Pittsburgh sleep quality index scores, sleep efficiency, Epworth Sleepiness Scale scores, inflammatory indices, pain, and enhanced recovery after surgery indices during hospitalization (< 0.05).

CONCLUSION

Psychological behavioral intervention combined with non-benzodiazepine can improve the perioperative quality of sleep. Compared with drug intervention alone, it reduces the dosage of non-benzodiazepine, alleviates anxiety, improves patient satisfaction, and enhances the quality of life.

摘要

目的

阐明心理行为干预联合非苯二氮䓬类药物改善膝关节置换术患者围手术期睡眠质量的有效性和安全性,并探索非苯二氮䓬类药物(口服酒石酸唑吡坦)的最佳剂量,以形成标准化的睡眠质量管理流程,促进患者加速康复。

方法

前瞻性纳入2016年1月至12月初次行单侧全膝关节置换术的240例患者,并将其随机分为空白对照组(A组)、心理行为干预组(B组)、酒石酸唑吡坦10 mg组(C组)和心理行为干预+酒石酸唑吡坦5 mg组(D组)。比较各组的睡眠、疼痛、心理及膝关节功能评分。

结果

四组患者在匹兹堡睡眠质量指数评分、睡眠效率、爱泼沃斯思睡量表评分、炎症指标、疼痛及住院期间术后加速康复指标方面差异均有统计学意义(<0.05)。

结论

心理行为干预联合非苯二氮䓬类药物可改善围手术期睡眠质量。与单纯药物干预相比,可以减少非苯二氮䓬类药物的用量,减轻焦虑情绪,提高患者满意度,提升生活质量。

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