产科腰硬联合麻醉后肢体幻像现象对患者焦虑情绪的影响

Effect of limb phantom on patients’anxiety after combined spinal epidural anesthesia in cesarean section

目的:探讨产科剖宫产患者腰硬联合麻醉后发生的肢体幻像现象对患者焦虑情绪的影响。方法:选取腰硬联合麻醉下行剖宫产的患者100例,入室前5 min对患者进行医院焦虑抑郁量表(HADS)评分,HADS评分≥11分者剔除。患者入室后自确定麻醉体位开始进行观察,对肢体幻像现象发生情况进行记录。对发生肢体幻像患者的焦虑发生情况进行HADS评分并记录、分析。探讨文化程度、初产妇或经产妇、首次和非首次剖宫产对发生肢体幻像现象患者焦虑情绪的影响。当肢体幻像现象消失后,再次对患者进行HADS评分。结果:100例剖宫产患者中,入室前5 min HADS评分≥11分者6例,予以剔除。HADS评分<11分者94例,其中72例发生肢体幻像现象,发生率高达76.60%。在72例发生肢体幻像现象患者中,焦虑情绪发生率高达68.06%。在22例未发生肢体幻像现象患者中,焦虑情绪发生率为4.55%。发生肢体幻像现象组与未发生肢体幻像现象组比较有统计学差异(P<0.05)。不同文化程度对发生肢体幻像现象患者的焦虑情绪有一定影响(P<0.05)。发生肢体幻像现象的患者中初产妇较经产妇更易产生焦虑情绪,首次剖宫产较非首次剖宫产患者更易产生焦虑情绪(P<0.05)。当肢体幻像现象消失后,发生肢体幻像现象患者与未发生肢体幻像患者焦虑情绪发生率比较无统计学差异(P>0.05)。结论:腰硬联合麻醉后发生肢体幻像现象患者较未发生肢体幻像现象患者更易产生焦虑情绪,文化程度、是否初产妇和首次剖宫产对发生肢体幻像现象患者焦虑情绪的产生有一定影响。

Objective:To investigate the effect of limb phantom on patients’anxiety after combined spinal epidural anesthesia in cesarean section.Methods:100 cases of cesarean section under combined spinal epidural anesthesia were selected.5 minutes before entering the operating room,the patients were scored with Hospital Anxiety and Depression Scale(HADS),and those with the HADS score≥11 were excluded.After entering the room,the anesthesia position of the patients were determined,and the occurrence of limb phantom was recorded.The incidence of anxiety in patients with limb phantom was scored by HADS and analyzed.The influence of education level,primipara and pluripara,first and non first cesarean section on anxiety of patients with limb phantom was explored.When the limb phantom disappeared,the patients were scored with the HADS again.Results:Among the 100 cases of cesarean section,6 cases with HADS score≥11 at 5 minutes before entering the room were excluded.94 cases had HADS score less than 11,72 of them had limb phantom,the incidence was 76.60%.In 72 patients with limb phantom,the incidence of anxiety was 68.06%.In 22 patients without limb phantom,the incidence of anxiety was 4.55%.There was significant difference between the group with and without limb phantom(P<0.05).Different education level had some influence on anxiety of patients with limb phantom(P<0.05).Among the patients with limb phantom,the primipara were more likely to have anxiety than pluripara,and the first cesarean section patients were more likely to have anxiety than those who did not(P<0.05).When the limb phantom disappeared,there was no significant difference in the incidence of anxiety between patients with and without limb phantom(P>0.05).Conclusion:Patients with limb phantom after combined spinal epidural anesthesia are more likely to have anxiety than those without limb phantom.The education level,primipara or not and the first cesarean section or not have some influence on the anxiety of patients with limb phantom.