术前抑郁心理对术后疼痛评分的影响

Preoperative psychological stress-depression-influence postoperat ive pain score significantly

目的观察手术对患者产生的不同心理应激反映,探讨术前心理应激状态对术后疼痛程度的影响。方法随机选择30例拟行腹腔镜胆囊切除术的患者,对所有患者均于手术前一晚应用SCL-90问卷进行心理状态评估,并于手术后8～24h对所有患者采用视觉模拟评分(VAS)及简化的McGill问卷(SF-MPQ)进行疼痛评分,研究术前SCL-90中躯体化、强迫、抑郁和焦虑4项因子的评分与术后疼痛评分的相关性。结果术前由于心理应激所造成的躯体化、强迫、抑郁和焦虑4个因子评分与术后8h的VAS、SF-MPQ疼痛评分有很好的正相关性(r>0.5,P<0.01),在术后24h,只有抑郁因子评分与VAS、SF-MPQ疼痛评分有很好的正相关性(r>0.5,P<0.01)。结论术后疼痛程度与术前心理应激状态呈正相关,并可显著影响程度强度和持续时间。

Aim To investigate the correlation betw een preoperative psychological stress and postopera tive pain.Methods The study sample included patients who underwent ele ctive laparoscopic cholecystectom y(n=30).At the night just prior to surgery,s ymptom check-list 90(SCL-90)was used to evaluate the preoperative psychological stress in all of the patients.The preoperative scores of four factors of SCL-90(somatization,compulsion,depression and anxiety)were recorded by a single observer.A t 8and 24hours after surgery,visual analogu e scale(VAS)and short form-McGill pain questionnaire(SF-MPQ)were used to evaluate postoperative pain.The cor-relation between the preoperative s cores of four factors of SCL-90and sc ores of the VAS and SF-MPQ were studied.Results At 8hours after surgery,postoperative pain scores have rela tions to preoperative somatization,com-pulsion,depression and anxiety(r>0.5,P<0.01);At 24hours after surgery,postoperative pain scores have only relations to preoperative de-pression(r>0.5,P<0.01).Conclusions Preoperative psychological stress,specially depression can in fluence postoperative pain significantly.