摘要
目的:分析全麻下甲状腺癌术患者术后睡眠障碍的危险因素,并探讨具体管理策略。方法:回顾性分析2022年1月—2024年2月河南大学第一附属于医院收治的123例甲状腺癌全麻手术患者的一般资料。根据患者术后睡眠质量的不同将其分为病例组和对照组,分析归纳可导致甲状腺癌患者全麻手术后睡眠障碍的危险因素,并据此探讨具体管理策略。结果:单因素分析结果显示,两组患者的年龄、麻醉方法、手术方法等一般资料以及术前睡眠情况、术后疼痛情况、术后内分泌功能、术后心理状态等临床资料比较,差异均有统计学意义(P<0.05)。logistic回归分析结果显示,年龄≥60岁、静息复合麻醉、非腔镜下手术、浅睡眠时间≥200 min、慢波睡眠时间≤40 min、术前快动眼睡眠期(REM)≤60 min、术后视觉模拟量表(VAS)评分≥6分、术后肿瘤坏死因子-α(TNF-α)≥4.3 ng/L、白细胞介素-6(IL-6)≥115 ng/L、褪黑素水平(MT)≤200 pg/mL、术后焦虑自评量表(SAS)≥40分、术后抑郁自评量表(SDS)≥50分均是导致患者术后睡眠障碍的危险因素。结论:甲状腺癌患者术后睡眠障碍的危险因素较多,合理选择麻醉及手术方法,在术后做好积极镇痛干预、心理疏导并调节机体内分泌功能,对降低睡眠障碍发生率有积极作用。
Objective:To analyze the risk factors of postoperative Sleep disorder in patients with subtotal thyroid cancer,and explore specific management strategies.Methods:The general and clinical data of 123 patients undergoing thyroid cancer surgery admitted to the First Affiliated Hospital of Henan University from January 2022 to April 2024 were retrospectively analyzed and classified as case group and control group.The risk factors leading to sleep disorders after general anesthesia in patients with thyroid cancer were analyzed and summarized,and the specific management strategies were discussed.Results:According to the single-factor analysis result,the general data(including age,anesthesia method and surgical method,etc.)were compared with the clinical data(including preoperative sleep status,postoperative pain,postoperative endocrine function,postoperative psychological state,etc.),and the difference was statistically significant(P<0.05).According to the logistic regression analysis result,age≥60 years old,resting combined anesthesia,non-endoscopic surgery,light sleep duration≥200 min,slow wave sleep duration≤40 min,rapid eye movement(REM)length≤60 min,postoperative visual analogue scale(VAS)score≥6 points,postoperative tumor necrosis factor(TNF)-α≥4.3 ng/L,interleukin(IL)-6≥115 ng/L,melatonin(MT)≤200 pg/ml,postoperative Self-Rating Anxiety Scale(SAS)score≥40 points Postoperative SDS score≥50 were risk factors leading to postoperative sleep disorders.Conclusion:There were many risk factors for sleep disorders in patients with thyroid cancer.Reasonable selection on the anesthesia and surgical methods,active postoperative analgesia intervention,psychological guidance,and adjustment of endocrine function have positive effects on reducing the incidence of sleep disorders.
作者
祁向雯
李洪影
白明松
Qi Xiangwen;Li Hongying;Bai Mingsong(Dept.of Anesthesiology,The First Affiliated Hospital of Henan University,Kaifeng,Henan,475000,China)
出处
《黑龙江医学》
2025年第21期2594-2597,共4页
Heilongjiang Medical Journal
基金
2023年度河南省医学科技攻关计划项目(LHGI20230416)。
关键词
甲状腺癌手术
全身麻醉
术后睡眠障碍
危险因素
管理策略
Thyroid cancer surgery
General anesthesia
Postoperative sleep disorder
Risk factor
Management strategy
