摘要
本文以自评、医师评定两种方式对腹部手术患者１０３例（除外精神科病史）进行围术期焦虑及干预的描述性研究。发现术前明显焦虑者占３０％，疑有焦虑者占３４％，无焦虑者占３６％。特质焦虑直接影响术前状态焦虑，疾病、手术因素影响术后焦虑，此时特质焦虑仍起作用。支持性心理治疗能降低术前焦虑，提高无并发症者满意程度，但对躯体预后无直接影响。另外，腹部手术患者入院时血皮质醇浓度高于正常人群。
The authors studied peri operative anxiety and the effect of corresponding intervention in 103 patients for elective abdominal operations,patients with a history of mental disorder were excluded before hand.The results by HAMA were that 36% patients had no signs of anxiety before operation,34% were in the rank of“maybe anxiety”,and the other 30% were obviously anxious as facing their operation.The scoring by HAMA was consistent with that obtained through STAI assessment.Anxiety of surgical patients was significantly higher than that of digestive inpatients.One′s preoperative anxiety correlated positively and directly to his trait anxiety which in step was influenced by sex and correlated positively to the post operative anxiety.The pre operative anxiety may reflect a patient′s personality more than the medical data in contrast with the post operative anxiety which influenced grossly by physical and operative conditions The pre operative anxiety was also positively correlate to woundache and painful recollection about surgical treatments.Supportive psychotherapy could lower pre operative anxiety,but had no effect on woundache or short term physical prognosis,what it can help was to raise the patients′ satisfaction for hospitalization,except for a few occasions with surgical complications.There was no linear or“U” shaped relationship between pre operative anxiety and short term physical prognosis,which correlated to medical data.The reason of this result may be that we excluded those with history of mental disorders before hand.The serum cortisol level of surgical patients on admission was higher than that of nomal population.Clonidine(0 075 mg bid)could lower the serum cortisol level and patients′ blood pressure and heart rate just before anesthesia,contrasting to the placebo group or to the data of themselves after admission,but it could add no more to the effect of supportive psychotherapy than placebo.
出处
《中国心理卫生杂志》
CSSCI
CSCD
北大核心
1997年第3期134-138,共5页
Chinese Mental Health Journal
关键词
围术期
焦虑
干预
peri operative,state anxiety,trait anxiety,intervention
