妇科腹腔镜手术患者术前焦虑抑郁状态对术后疼痛的影响

Effect of preoperative anxiety and depression on postoperative pain in patients undergoing gynecological laparoscopic surgery

目的探讨妇科腹腔镜手术患者术前焦虑抑郁状态对术后疼痛的影响。方法选取2017年5月至2019年5月如皋磨头医院妇科进行腹腔镜手术的60例患者,术前访视时研究采用医院焦虑抑郁量表(HADS)对患者抑郁以及焦虑的状态进行评估,将评分≥9分划分为研究组,<9分为对照组,每组60例。比较不同的焦虑状态对患者术后疼痛情况、排气时间以及不良反应发生率等因素的影响。结果两组手术结束6 h时视觉模拟评分(VAS)得分比较,研究组疼痛程度显著高于对照组(P<0.05);两组其他时间节点比较,差异无统计学意义(P>0.05)。两组患者镇痛药物使用效果比较,差异无统计学意义(P>0.05),对照组排气时间显著短于研究组(P<0.05)。两组HADS评分与手术结束6 h时VAS评分比较,差异有统计学意义(P<0.05)。研究组不良反应发生率为6.7%,低于对照组的26.7%,差异有统计学意义(P<0.05)。结论高度的焦虑抑郁状态会导致患者术后6 h疼痛显著增加,同时在一定程度上会延长排气时间。

Objective To investigate the effect of preoperative anxiety and depression on postoperative pain in patients undergoing gynecologic laparoscopic surgery.Methods From May 2017 to May 2019,60 patients underwent laparoscopic surgery in the gynecology department of the Datoutou Hospital.The preoperative visit was evaluated using the Hospital Anxiety and Depression Scale(HADS)to assess the state of depression and anxiety.The scores≥9 were divided into study groups,and<9 was divided into control groups.The effects of different anxiety states on postoperative pain,exhaust time and incidence of adverse reactions were compared.Results The visual analog scale(VAS)scores at 6 h after surgery were significantly higher in the study group than in the control group(P<0.05).There was no significant difference between the two groups(P>0.05).There was no significant difference in the use of analgesic drugs between the two groups(P>0.05).The exhaust time of the control group was significantly shorter than that of the study group(P<0.05).The HADS scores of the two groups were compared with the VAS scores at 6 h after surgery,and the difference was statistically significant(P<0.05).The incidence of adverse reactions in the study group was 6.7%,which was lower than that in the control group(26.7%).The difference was statistically significant(P<0.05).Conclusion High levels of anxiety and depression can lead to a significant increase in pain at 6 hours postoperatively,and at some point prolonged exhaustion..