髋关节置换术患者围手术期焦虑状况及影响因素研究

Analysis of the anxiety in patients with total hip replacement during perioperation and the influencing factors

目的：了解髋关节置换术患者围手术期的焦虑状况以及与之相关的社会心理影响因素。方法：对47例髋关节置换术患者应用汉密顿焦虑量表评估患者焦虑状态,并采用自制一般问卷、手术状况调查表调查患者焦虑相关因素。结果：手术前有焦虑症状者31例,手术后有焦虑症状者17例,手术前汉密顿焦虑量表总分显著高于手术后（P〈0.01）;手术后焦虑与术前焦虑状态呈正相关关系;患者的焦虑状态与双髋关节置换与否、是否发生术后并发症、关节功能恢复状况、经济状况、对疾病与手术认知程度、亲友支持等因素均存在相关性（P〈0.05-P〈0.01）。结论：患者髋关节置换术前焦虑症状的发生率较手术后高,且术前有焦虑情绪者术后发生焦虑的危险性明显增高;焦虑状态与手术、社会支持等多种因素有相关性。

Objective：To analyze the anxiety in patients with total hip replacement during perioperation and the related psychosocial factors. Methods：The anxious status of 47 patients receiving total hip replacement were evaluated by Hamilton depression rating scale （HAMD）, and the influencing factors were assessed by self-designed questionnaire and operation questionnaire. Results： Anxiety symptoms were noted in 31 cases before operation and in 17 cases after operation. The preoperative scores on HAMD were significantly higher than that in the postoperative ones. Postoperative anxiety was positively correlated to the preoperative anxiety symptoms （P 〈 0.01 ）. The anxiety was related to the operation, postoperative complication,joint functional recovery, cost of treatment, acknowledge to the disease and postoperative support from relatives and friends （P 〈 0.05 to P 〈 0.01 ）. Conclusions：The incidence of postoperation anxiety in patients receiving total hip replacement is higher than that after operation. Patients with pre-operation anxiety symptoms have a higher risk of postoperative anxiety. The anxiety in patients with total hip replacement is correlated to the factors such as the condition of the operation, social support and so on.