妇科腹腔镜手术前后患者情感障碍相关因素分析及护理对策.docVIP

妇科腹腔镜手术前后患者情感障碍相关因素分析及护理对策 【摘要】目的了解妇科腹腔镜手术前后患者的情感障碍相关因素，探讨缓解对策。方法应用抑郁、焦虑自评量表（SDS，SAS）和汉密尔顿抑郁、焦虑量表（HAMD、HAMA）对110例妇科腹腔镜手术患者手术前后进行测评，辅以自行设计影响因素调查表进行相关因素调查。结果手术前患者SDS、SAS和HAMD、HAMA评分分别为56.3±5.2、54.4±6.2和22.3±4.1、17.3±2.6；手术后42.2±3.7、43.4±5.1和14.5±3.5、12.7±1.8，与治疗前比较差异有显著统计学意义（P0.01）。单因素分析发现婚姻关系、睡眠质量、对手术和麻醉的恐惧感、对疼痛的恐惧感、对疾病的了解程度、对医护水平的担心、担心病理结果等与情感障碍的发生显著相关（P0.05；＜0.01）。结论妇科腹腔镜手术前患者存在抑郁、焦虑等情感障碍，与多种因素相关，术前进行心理护理干预很有必要。 【关键词】 手术 腹腔镜 抑郁 焦虑 干预 Study on correlation factors of emotional disorder in patients with gynecological disease before and after laparoscopic operation and nursing countermeasures XU Jian-wen，ZHANG Jian，JIANG Xiu-wen.Shidong Hospital in Yangpu District of Shanghai，Shanghai 200438，China ［Abstract］ Objective To study the correlation factors of emotional disorder in patients with gynecological disease before and after laparoscopic operation and nursing countermeasure.Methods Anxious and depressed disorders of one hundred and ten patients with gynecological disease were evaluated by SDS,SAS,HAMD and HAMA before and after laparoscopic operation.Results Before operation，the scores of SDS,SAS,HAMD and HAMA were 56.3±5.2,54.4±6.2,22.3±4.1 and 17.3±2.6；After operation，they were 42.2±3.7,43.4±5.1,14.5±3.5 and 12.7±1.8.There was significant difference before and after laparoscopic operation（P0.01）.One-factor analysis showed that there was significant correlation between emotional disorder and such factors as marriage relation,sleep quality,horror of operation,anesthesia and pain,understanding of disease,worry of medical level and pathological result（P0.05;＜0.01）.Conclusion Anxious and depressed disorders were common in patients with gynecological disease before laparoscopic operation and mental nursing is necessary. ［Key words］ operation；laparoscopy；depression；anxiety；countermeasure 随着医学内镜技术水平的不断提高，腹腔镜手术正改变着妇科疾病传统的诊断和治疗模式，它以创伤小、出血少、术后恢复快等优点，逐渐成为许多妇科疾病的首选手术模式，被愈来愈多的患者所接受，但腹腔镜手术前多数患者伴有不同程度的情感障碍，研究表明患者的情感障碍对手术预后有很大影响［1］，不良的情绪往往导致患者的生命质量下降，影响治疗的效果［2］。我院妇科2005年1月～2006