| 周春容,游 晴,付 敏,黄红梅,周 丹,马 建.外伤性肝破裂患者腹腔镜下修补术后发生焦虑抑郁的危险因素分析[J].,2019,19(14):2695-2698 |
| 外伤性肝破裂患者腹腔镜下修补术后发生焦虑抑郁的危险因素分析 |
| Risk Factors of Anxiety and Depression after Laparoscopic Repair in Patients with Traumatic Liver Rupture |
| 投稿时间：2019-02-20 修订日期：2019-03-15 |
| DOI：10.13241/j.cnki.pmb.2019.14.019 |
| 中文关键词: 外伤性肝破裂 腹腔镜下修补术 焦虑 抑郁 |
| 英文关键词: Liver traumatic rupture Laparoscopic repair Anxiety Depression |
| 基金项目:国家自然科学基金项目(81501521)；重庆市科技传播与普及项目(cstc2016kp-sfhdB009) |
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| 中文摘要: |
| 摘要 目的：探讨外伤性肝破裂患者腹腔镜下修补术后发生焦虑抑郁的危险因素。方法：应用前瞻性研究方法，采用一般资料问卷调查表、焦虑自评量表、抑郁自评量表对本院收治的150例外伤性肝破裂患者进行心理测评，分析术后焦虑和抑郁状态的发生情况。根据术后的状态分为三组，术后存在焦虑的患者为焦虑状态组(n=53)，存在抑郁状态的患者为抑郁状态组(n=57)，术后无焦虑抑郁状态的为对照组(n=40)。对焦虑和抑郁形成的危险因素进行多因素Logistic回归分析。结果：焦虑状态组(n=53)、抑郁状态组(n=57)及对照组(n=40)平均年龄、平均受教育年限比较差异无统计学意义(P＞0.05)；而经济月收入、居住地、负面情绪、术前并发症、医保报销、家庭和睦、术前住院时间差异具有统计学意义(P<0.05)。手术过程的手术时间、外循环时间、主动脉阻断时间、外循环百分比比较差异均无统计学意义(P＞0.05)；而麻醉苏醒时间、ICU停留时间差异具有统计学意义(P<0.05)。术后担忧的问题及需求(治疗需求和心理需求)比较差异均具有统计学意义(P＜0.05)。Logistic回归分析结果显示文化程度(OR=1.254)、负面情绪(OR=1.245)、家庭收入(OR=2.324)、手术疗效(OR=2.258)均为焦虑发生的危险因素；文化程度(OR=4.230)、负面情绪(OR=1.254)、家庭收入(OR=1.236)、手术疗效(OR=2.120)均为抑郁发生的危险因素。结论：外伤性肝破裂患者腹腔镜下修补术后焦虑抑郁的形成可能与患者的文化高低、负面情绪、手术疗效、家庭收入和术前并发症有关。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the risk factors of anxiety and depression in patients with traumatic liver rupture after laparoscopic repair. Methods: In this prospective study, 150 patients with traumatic liver rupture were assessed with general information questionnaire, self-rating anxiety scale and self-rating depression scale to evaluate the incidence of post-operative anxiety and depression. According to the state of patients after operation, the patients with anxiety after operation were anxiety group (n=53), patients with depression were depression group (n=57) and control group were consist of those who have no anxiety and depression(n=40). The risk factors of anxiety and depression were analyzed by multivariate Logistic regression analysis. Results: There was no significant difference in average age and education years among anxiety group (n=53), depression group (n=57) and control group (n=40)(P>0.05). The difference of monthly income, residence, negative emotion, preoperative complications, medical insurance reimbursement, family harmony, preoperative hospitalization time was statistically significant. The operative time, the time of external circulation, the time of aortic occlusion and the number of cases of external circulation had not significant differences(P>0.05), but differences of anaesthetic resuscitation time and the residence time of ICU were statistically significant (P<0.05). Postoperative concerns and needs (both therapeutic and psychological) and risk factors of anxiety were significant different(P<0.05). Logistic regression analysis showed that education level (OR=1.254), negative emotion (OR=1.245), family income (OR=2.324) and surgical effect (OR=2.258) were risk factors for anxiety. Education level (OR=4.230), negative emotions (OR=1.254), family income (OR=1.236), and surgical efficacy (OR=2.120) were risk factors for depression. Conclusion: The incidence of anxiety and depression in patients with traumatic liver rupture after laparoscopic repair may be related to the level of culture, negative emotion, operative efficacy, family income and preoperative complications. |
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