病态肥胖症患者腹腔镜袖状胃切除术前心理状态及影响因素分析

Analysis of the psychological status and the influencing factors in patients with morbid obesity before laparoscopic sleeve gastrectomy

目的:评估病态肥胖症患者行腹腔镜袖状胃切除术前的心理状态,并进一步探讨影响其心理状态的潜在临床指标。方法:回顾分析2020年10月至2021年8月拟行腹腔镜袖状胃切除术的病态肥胖症患者的临床资料,通过心理量表评估其体重内在化歧视、睡眠质量、饮食行为、自尊、生活质量、焦虑及抑郁水平,并与临床指标进行Pearson相关性分析,探讨影响心理状态的潜在因素。结果:最终纳入271例病态肥胖症患者,平均(31.98±7.32)岁,体重指数平均(41.93±7.84)kg/m 2,男86例(31.73%)。经评估,其体重内在化歧视量表平均(50.67±11.73)分,匹兹堡睡眠质量指数量表平均(7.12±3.57)分,生活质量量表平均(64.96±18.50)分,健康变化平均(32.84±20.88)分,100例(36.90%)存在不同程度的焦虑,108例(39.85%)存在不同程度的抑郁,各基线指标与心理状态显著相关。结论:病态肥胖症患者具有较高的体重内在化歧视、焦虑及抑郁水平,较低的睡眠质量、健康变化得分及生活质量水平。术前心理状态受一系列临床指标影响。严格的术前心理评估有助于制定围手术期个体化的心理干预措施。

Objective:To evaluate the psychological status of morbid obesity patients prior to laparoscopic sleeve gastrectomy(LSG)and to further explore potential clinical indicators affecting their psychological status.Methods:The clinical data of morbidly obese patients undergoing LSG from Oct.2020 to Aug.2021 were retrospectively analyzed.Weight bias internalization,sleep quality,eating b ehavior,self-esteem,quality of life,anxiety and depression levels were assessed by psychological scales,Pearson correlation analysis was conducted with clinical indicators to explore the potential factors affecting psychological state.Results:Two hundred and seventy-one morbidly obese patients were included,with an average age of(31.98±7.32)years and an average body mass index of(41.93±7.84)kg/m 2,86(31.73%)were male.They were assessed with an average score of(50.67±11.73)on the weight bias internalization scale,(7.12±3.57)on the Pittsburgh sleep quality index,(64.96±18.50)on the Mos 36-item short form health survey,(32.84±20.88)on the health transition,100(36.90%)of the patients had varying degrees of anxiety,108(39.85%)patients had varying degrees of depression,and there was a significant correlation between the baseline indicators and psychological status.Conclusions:The obesity patients have higher levels of weight bias internalization,anxiety and depression,and lower levels of sleep quality,health transition and quality of life.Preoperative psychological status is influenced by a range of clinical indicators.Rigorous preoperative psychological assessment helps to develop individualized psychological interventions in the perioperative period.