术前焦虑状态对肺癌手术患者术后早期康复的影响

Effect of preoperative anxiety on early postoperative rehabilitation of patients with lung cancer surgery

目的:研究术前焦虑状态对肺癌手术患者术后早期康复的影响。方法:选择某院2018月5月到2020年5月140例肺癌手术患者作为研究对象,根据其术前汉密尔顿焦虑量表(HAMA)评分,将其分为无焦虑组和焦虑组。比较两组的一般资料,术后情况,术后6、12、24、48h的视觉模拟评分(VAS)、术后炎性介质、创伤后成长评定量表(PTGI)、并发症。结果:根据HAMA评分<7分、≥7分设为无焦虑组(45例)、焦虑组(95例)。两组的性别、年龄比较,差异均无统计学意义(P>0.05);无焦虑组的TNM分期显著低于焦虑组,差异有统计学意义(Z=18.107,P<0.05)。两组的下床活动时间比较,差异无统计学意义(P>0.05);无焦虑组的创口愈合时间、住院时间显著低于焦虑组,差异均有统计学意义(t=-6.829,-9.080;P<0.05)。两组术后1d的VAS评分比较,差异无统计学意义(P>0.05);无焦虑组术后3d、7d的VAS评分显著低于焦虑组,差异均有统计学意义(t=-12.886,-27.032;P<0.05)。无焦虑组术后的CRP、IL-6、IL-10、TNF-α显著低于焦虑组,差异均有统计学意义(t=-10.531,-13.731,-8.059,-8.990;P<0.05)。无焦虑组PTGI评分(63.94±6.57分)显著高于焦虑组PTGI评分(58.15±5.42分),差异有统计学意义(t=5.506,P<0.05)。无焦虑组并发症发生率8.89%,显著低于焦虑组并发症发生率24.21%,差异有统计学意义(χ^(2)=4.605,P<0.05)。结论:术前焦虑情绪的持续存在会导致肺癌手术患者术后早期康复缓慢,疼痛加剧,炎症水平及并发症发生率升高。

Objective:To study the effect of preoperative anxiety on early postoperative rehabilitation of patients with lung cancer surgery.Methods:A total of 140 patients with lung cancer surgery from May 2018 to May 2020 were selected as the study subjects.They were divided into the anxiety-free group and the anxiety group according to its preoperative Hamilton anxiety scale(HAMA)score.The postoperative conditions of the two groups were compared.The visual analogue scale(VAS),postoperative inflammatory mediators,post-traumatic growth assessment scale(PTGI),and complications at 6,12,24,and 48 hours after surgery were compared.Results:According to the HAMA score<7 points,≥7 points,the anxiety-free group(45 cases)and the anxiety group(95 cases)were selected.There was no statistically significant difference in gender and age between two groups(P>0.05).The TNM staging of the anxiety group was significantly lower than that of the anxiety group,and the difference was statistically significant(Z=18.107,P<0.05).There was no significant difference in the time of getting out of bed between two groups(P>0.05).The wound healing time and hospital stay of the anxiety-free group were significantly lower than those of the anxiety group,and the differences were statistically significant(t=-6.829,-9.080;P<0.05).There was no significant difference in VAS score between the two groups on the first day after operation(P>0.05);The VAS scores at 3 and 7 days after operation in the non anxiety group were significantly lower than those in the anxiety group(t=-12.886,-27.032;P<0.05).The postoperative CRP,IL-6,IL-10,and TNF-α of the anxiety-free group were significantly lower than those of the anxiety group,and the differences were statistically significant(t=-10.531,-13.731,-8.059,-8.990;P<0.05).The PTGI score of the anxiety-free group(63.94±6.57)was significantly higher than the PTGI score of the anxiety group(58.15±5.42),and the difference was statistically significant(t=5.506,P<0.05).The complication rate of the anxiety-free group was 8.89%,which was significantly lower than the complication rate of the anxiety group of 24.21%.The difference was statistically significant(2=4.605,P<0.05).Conclusion:The persistence of preoperative anxiety leads to slow recovery of patients with lung cancer surgery in the early postoperative period,increases pain,inflammation levels and incidence of complications.