术前焦虑对胸腔镜肺癌根治术后患者早期预后的影响  

Effect of Preoperative Anxiety on Early Prognosis of Patients after Thoracoscopic Lung Cancer Resection

作　　者：张云霄[1] 李宗超 陈冀衡[1] 范志毅[1] Yunxiao ZHANG;Zongchao LI;Jiheng CHEN;Zhiyi FAN(Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing),Department of Anesthesiology,Peking University Cancer Hospital and Institute,Beijing 100142,China)

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所麻醉科恶性肿瘤发病机制及转化研究教育部重点实验室

出　　处：《中国肺癌杂志》2019年第11期714-718,共5页Chinese Journal of Lung Cancer

摘　　要：背景与目的肺癌患者常伴焦虑,影响术后恢复。本研究旨在观察术前焦虑对胸腔镜肺癌根治术后患者早期预后的影响。方法以胸腔镜肺癌根治术患者100例为研究对象,术前采用医院焦虑抑郁量表(hospital anxiety and depression scale,HADS)对患者进行评估,其中焦虑患者44例(焦虑评分≥8分)纳入焦虑组;非焦虑患者56例(焦虑评分<8分)纳入对照组,术后随访患者早期预后指标。主要研究终点:患者术后住院时间;次要研究终点:患者总住院时间、术后视觉模拟疼痛评分(visual analogue scale,VAS)、术后恶心呕吐及新发心律失常发生率、术后镇痛药和补救止吐药用量。结果相对于对照组,焦虑组术后住院时间及总住院时间均明显延长[(5.1±2.5)d vs(4.0±1.3)d,P<0.01;(10.9±4.0)d vs(9.1±4.1)d,P<0.05];术后VAS评分、恶心及新发心律失常发生率显著增高[(4.7±1.9)分vs(2.6±1.8)分,P<0.001;40.9%vs 16.1%,P<0.01;36.4%vs 20.7%,P<0.05];术后镇痛药和补救止吐药用量增多[(72.5±8.9)m L vs(68.2±9.4)m L,P<0.05;(2.1±2.9)mg vs(0.9±1.9)mg,P<0.05]。结论术前焦虑可影响胸腔镜肺癌根治术后患者早期预后,延长住院时间,增加患者术后VAS评分、恶心及新发心律失常发生率,增加术后镇痛药及补救止吐药用量。Background and objective Patients with lung cancer are often accompanied by anxiety,which affects postoperative recovery.The aim of this study is to explore the effects of preoperative anxiety on early prognosis in patients after thoracoscopic lung cancer resection.Methods A total of 100 patients undergoing thoracoscopic resection of lung cancer were divided into 2 groups by hospital anxiety and depression scale(HADS):44 in anxiety group(anxiety score>8)and 56 in control group(anxiety score<8).The primary endpoint:length of postoperative hospital stay.The secondary endpoint:length of hospital stay,visual analogue scale(VAS),the incidence of nausea and vomiting as well as postoperative new arrhythmia and the consumption of postoperative analgesic and rescue antiemetic.Results Compared with the control group,the length of postoperative hospital stay and hospital stay in the anxiety group were both significantly longer[(5.1±2.5)d vs(4.0±1.3)d,P<0.01;(10.9±4.0)d vs(9.1±4.1)d,P<0.05)],the VAS score and the incidence of nausea as well as arrhythmia were significantly increased[(4.7±1.9)vs(2.6±1.8),P<0.001;40.9%vs 16.1%,P<0.01;36.4%vs 20.7%,P<0.05],and the consumption of postoperative analgesic and rescue antiemetic were also significantly increased[(72.5±8.9)m L vs(68.2±9.4)m L,P<0.05;(2.1±2.9)mg vs(0.9±1.9)mg,P<0.05].Conclusion Preoperative anxiety can affect the early prognosis of patients after thoracoscopic lung cancer resection,prolong hospitalization time,increase the postoperative pain score and the incidence of postoperative nausea and new arrhythmia as well as the consumption of postoperative analgesic and rescue antiemetic.

关 键 词：焦虑 肺肿瘤 胸腔镜 术后恢复 

分 类 号：R73[医药卫生—肿瘤]