正颌外科治疗前后患者容貌变化及满意度的研究

Study on appearance changes in patients with orthognathic surgery and their satisfaction

目的正颌外科是改造牙颌面结构达到功能和美貌统一的理想手段。研究正颌外科患者容貌改变前后的心理变化,分析其对疗效的影响和应对措施。方法对42例正颌外科患者进行综合问卷调查,记录各种心理因素包括治疗动机、审美要求、治疗效果期望值等。比较正颌患者术前及术后各阶段心理健康水平,评估主观心理变化、疗效及满意度之间的关系。结果在SCL-90评定中,治疗后9个因子得分及总分均明显低于治疗前,尤其以人际关系敏感、抑郁、焦虑、敌对4个因子最为显著,差异有统计学意义(P<0.01)。在SDS、SAS评定中,治疗前后比较差异有统计学意义(P<0.01)。结论正颌外科术后患者外貌得到改善,其疗效与患者心理状态关系较密切。治疗中医师对其心理问题可进行正确引导,为正颌外科治疗提供心理干预的参考。

Objective Orthognathic surgery is an ideal means which transform the dentofacial structure to attain the uniformity of function and beauty. To study the psychological factors of the orthognathic surgery patients, and to analyze their effect on the treatment to find the corresponding treatment measures. Methods To conduct a comprehensive questionnaire for the 42 cases of orthognathic surgery patients and record all kinds of psychological factors including patients motivation, aesthetic demands, patients expectations, etc. To compare the level of mental health on each stage of preoperative and postoperative treatment, to assess the subjective psychological changes and therapeutic effect,and analyze the relationship between satisfactions. Results After treatment,in the SCL-90 of nine factors scores,the scores were significantly lower than before treatment,in particular to the four factors：interpersonal sensitivity,depression,anxiety and hostile were most significant （P〈0.01）. In the SDS and SAS evaluation, the comparison of the before and after treatment had significant difference （P〈0.01）. Conclusion The treatment of orthognathic surgery improves the patients＇ appearance and enhances their self-confidence, which is conducive to physical and mental health. The efficacy of the treatment is closely related to patients＇ psychological treatment. This study provides the consultation of psychological intervention for orthognathic surgery.