腰椎间盘突出症患者术前焦虑与术后恢复的关系

Pre-operative Anxiety and Post-operative Recovery in Patients Undergoing Lumbar Surgery

目的:探讨腰椎间盘突出症患者术前焦虑情绪与术后疼痛、术后恢复的关系。方法:用医院焦虑抑郁量表(hospital anxiety and depressionscale,HADS)评估行腰椎间盘手术的54例患者的焦虑情绪,以≥8分判为有焦虑情绪;用疼痛量表评估患者的疼痛程度,并记录病情恢复情况。用卡方检验,t检验比较焦虑组和非焦虑组的差异情况。结果:54例患者中有25例有焦虑;睡眠情况、对手术的认知程度、手术费用的承受能力与焦虑水平相关(OR=0.495,0.657,1.485)。在术后6小时、2天、5天时,焦虑组的疼痛得分高于非焦虑组的疼痛得分[(9.0±4.1)vs.(6.0±3.4),(12.5±4.2)vs.(10.0±3.5),(4.5±1.6)vs.(2.5±1.2);均P<0.05]。焦虑组患者的住院时间长于非焦虑组患者[(12.5±2.3)dvs.(9.7±2.1)d,P=0.008],排尿困难发生率高于非焦虑组患者(32%vs.17%,P=0.006)。腰腿疼在术后第2天、第5天、1个月时焦虑组评分高于非焦虑组[(14.0±3.7)vs.(11.5±3.5),(9.5±4.2)vs.(6.5±3.3),(7.0±4.3)vs.(4.5±2.8);P<0.05]。结论:术前焦虑情绪影响术后刀口疼痛,术前焦虑与术后恢复有关。

Objective： To investigate the relationship of pre-operative anxiety with pain after surgery and recovery in patients with lumbar disc herniation. Methods： The Hospital anxiety and depression scale was used to assess the anxiety level in 54 patients who received lumbar surgery. Those who got 8 or higher score were divided into the case group. Their degree of pain was assessed with the McGill questionnaire. The difference was compared between case group and non-case group by chi-square test and t test. Results： Twenty-five of the 54 patients were classified into the case group. Anxiety level was associated with sleeping status, knowledge of the surgery and the ability to afford the surgery （ OR values were 0. 495, 0. 657, and 1. 485 respectively ） . Post-surgery pain at the operative site had significant difference between case group and non-case group at time points of six hours, two days and five days after surgery [ （9.0±4.1） vs. （6.0±3.4）, （12.5±4.2） vs. （10.0±3.5）, （4.5±1.6） vs. （2.5±1.2）; P〈0.05] ± Patients with anxiety had longer stay in hospital than those without anxiety [ （ 12. 5 ± 2. 3 ） d vs. （ 9. 7 ± 2. 1 ） d, P = 0. 008 ] . People with pre-operative anxiety were more prone to have difficulty in urinating after surgery than those without anxiety （32% vs. 17%, P =0. 006） . The melosalgia scores were higher in case group than in non-case group at the time points of six hours, two days and five days after surgery [ （ 14.0 ± 3.7 ） vs. （ 11.5 ± 3.5 ）, （ 9.5 ± 4. 2 ） vs. （6. 5 ± 3. 3 ）, （ 7.0 ± 4. 3 ） vs. （4.5 ± 2. 8 ） ; P 〈 0. 05 ] . Conclusion： Pre-oporative anxiety is probably related to higher pain degree after surgery and lower recovery rate.