剖宫产疤痕妊娠患者子宫动脉栓塞术前焦虑对术后疼痛影响的临床观察

Clinical observation of the effect of preoperative anxiety on postoperative pain in cesarean scar pregnancy patients undergoing uterine artery embolization

目的探讨术前焦虑状态对剖宫产疤痕妊娠(CSP)患者子宫动脉栓塞术(UAE)后疼痛的影响。方法选取2017年3-7月新疆医科大学第一附属医妇科收治的剖宫产疤痕妊娠并实施子宫动脉栓塞术的67例患者为研究对象,给符合纳入标准的67例患者在知情同意书上签字后发放焦虑自评量表(SAS),并根据SAS评分结果分为焦虑组(34例)和无焦虑组(33例),子宫动脉栓塞术后利用数字疼痛评分法(NRS)给患者术后不同时间点(即术后0、2、6、12、24h)疼痛程度评分并记录并发症的发生和使用止痛药物情况。结果焦虑组患者术后2、6、12h疼痛评分均高于无焦虑组患者,差异有统计学意义(P<0.05)。2组患者术后不同程度的疼痛发生比例差异有统计学意义(P<0.05)。2组患者术后并发症发生差异无统计学意义(P>0.05),但术后止痛药物使用人次数比较差异有统计学意义(P<0.05),焦虑组患者使用止痛药物人次数较无焦虑组多。结论剖宫产疤痕妊娠患者术前焦虑影响子宫动脉栓塞术后疼痛程度,增加术后使用止痛药物人次数,在子宫动脉栓塞术前充分评估患者心理状态有助于患者得到及时个性化的疼痛治疗和护理,提高患者满意度。

Objective To investigate the effect of preoperative anxiety on pain after uterine artery embolization(UAE)in patients with CSP.Methods 67 patients with cesarean scar pregnancy and uterine artery embolization in department of gynaecology in the first affiliated hospital of Xinjiang medical university from March to July 2017 were enrolled as the subjects for study.67 patients who met the inclusion criteria were given self-rating anxiety scale(SAS)after signing the informed consent form.According to the SAS scores,they were divided into anxiety group(34 cases)and non-anxiety group(33 cases).After uterine arterial embolization,the patients were given pain scores at different time points(i.e 0,2,6,12,24 h)by Numerical rating scale and recording the occurrence of complications and the use of analgesic drugs.Results The postoperative pain score of anxiety group was higher than that of non-anxiety group(P <0.05).There was significant difference in the incidence of postoperative pain between the two groups(P <0.05).There was no significant difference in postoperative complications between the two groups(P >0.05).However,there was significant difference in the number of postoperative analgesic drug users(P <0.05)and the number of analgesic drug users in anxiety group was more than that in no anxiety group.Conclusion Preoperative anxiety of cesarean scar pregnancy patients can affect the degree of pain after uterine arterial embolization and increase the number of postoperative use of analgesic drugs.To fully assess the psychological state of patients before the uterine artery embolization can help patients get timely personalized pain treatment and care,which can improve patients satisfaction.