下颌角截骨术对女性患者心理影响的研究

Psychological effects of the mandibular angle osteotomy on female patients

目的:探讨下颌角肥大女性患者接受下颌角截骨整形手术(mandibular angle osteotomy,MAO)前、后心理状态。方法:2020年2月至2021年7月,海军军医大学第二附属医院烧伤整形外科就诊并接受双侧下颌角截骨整形术女性患者36例,年龄18~35岁,平均23岁。用症状自评量表(SCL-90)、焦虑自评量表(SAS)、抑郁自评量表(SDS)对患者手术前、后心理状态进行问卷调查。用SPSS 18.0等统计软件将手术前、后数据与国内常模进行比较。结果:SCL-90问卷调查显示,术前患者在强迫症状(2.24±0.43比1.62±0.58,P<0.01)、人际关系敏感(1.85±0.46比1.65±0.61,P=0.02)、抑郁(1.91±0.43比1.50±0.59,P<0.01)、焦虑(1.75±0.42比1.39±0.43,P<0.01)、敌对(1.86±0.45比1.46±0.55,P<0.01)、偏执(2.18±0.46比1.43±0.57,P<0.01)等6个指标的因子分均高于国内常模值。术后1个月,患者SAS、SDS评分较术前显著改善,SAS评分由43.0±9.8降至37.5±6.8,SDS评分由47.1±10.6降至39.4±7.5(t=8.0、10.4,P<0.01)。SCL-90抑郁、焦虑等指标与国内常模值比较,差异无统计学意义(P>0.05)。结论:下颌角截骨整形术后患者心理健康水平明显改善,可缓解患者焦虑或抑郁等情绪。

Objective To explore the psychological status of female patients with mandibular angle hypertrophy before and after receiving mandibular angle osteotomy(MAO)using psychological measurement methods.Methods The study included 36 female patients(age ranged 18-35 years,with mean age of 23 years)who underwent bilateral mandibular angle osteotomy at the Department of Burns and Plastic Surgery,Naval Medical University.Symptom Checklist-90(SCL-90),Self-Rating Anxiety Scale(SAS),and Self-Rating Depression Scale(SDS)were used to assess the patients′psychological status before and after surgery.SPSS 18.0 was used to compare the preoperative and postoperative data with the national norms.Results According to the SCL-90 questionnaire,the scores of the six factors,including obsessive-compulsive symptoms(2.24±0.43 vs.1.62±0.58,P<0.01),interpersonal sensitivity(1.85±0.46 vs.1.65±0.61,P=0.02),depression(1.91±0.43 vs.1.50±0.59,P<0.01),anxiety(1.75±0.42 vs.1.39±0.43,P<0.01),hostility(1.86±0.45 vs.1.46±0.55,P<0.01),and paranoia(2.18±0.46 vs.1.43±0.57,P<0.01)of patients before surgery were significantly higher than the national norms.One month after surgery,there was a significant improvement in SAS and SDS scores compared to preoperative scores(t=8.0,10.4,P<0.01).The SAS score decreased from 43.0±9.8 to 37.5±6.8,and the SDS score decreased from 47.1±10.6 to 39.4±7.5.There was no statistically significant difference in the depression and anxiety indices of SCL-90 compared to the national norms(P>0.05).Conclusions Mandibular angle osteotomy significantly improves the psychological health of female patients with mandibular angle hypertrophy and can alleviate the symptoms of anxiety and depression.