睡眠质量和焦虑抑郁在腹部手术患者术前疼痛灾难化与术后早期疼痛中的作用  

The role of sleep quality and anxiety-depression on preoperative pain catastrophizing and early postoperative pain in patients undergoing abdominal surgery

作　　者：姚国美 姚红瑛 沈云霞 曹丽英 金超杰 YAO Guomei;YAO Hongying;SHEN Yunxia;CAO Liying;JIN Chaojie(Operating Room,Linping Hospital,the Second Affiliated Hospital of Zhejiang University School of Medicine,Hangzhou,Zhejiang 311100,China)

机构地区：[1]浙江大学医学院附属第二医院临平院区手术室,浙江杭州311100

出　　处：《中华全科医学》2023年第12期2060-2063,共4页Chinese Journal of General Practice

基　　金：浙江省医药卫生科技计划项目(2023XY011)。

摘　　要：目的探讨腹部手术患者睡眠质量和焦虑抑郁在术前疼痛灾难化与术后早期疼痛中的中介作用,为制定减轻术后早期疼痛的干预方案提供依据。方法选取浙江大学医学院附属第二医院临平院区2021年1月—2022年1月行腹部手术的患者206例,采用疼痛灾难化量表(PCS)、医院焦虑抑郁量表(HADS)、匹兹堡睡眠质量指数(PSQI)、视觉模拟评分(VAS)进行评估,采用Pearson相关性分析研究腹部手术患者睡眠质量和焦虑抑郁在术前疼痛灾难化和术后早期疼痛间的相关性,并进行中介效应检验。结果共发放206份问卷,回收192例有效问卷,问卷回收率为93.20%,其中男性104例,女性88例,年龄为(54.95±7.89)岁。Pearson相关分析显示:术前疼痛灾难化与术后早期疼痛、焦虑抑郁、睡眠质量呈正相关关系(r=0.813、0.745、0.792,均P<0.001),术后早期疼痛与焦虑抑郁、睡眠质量呈正相关关系(r=0.834、0.842,均P<0.001)。Bootstrap法结果显示:3条路径中介效应值为0.106,总中介效应占总效应的62.35%,其中路径1(术前疼痛灾难化→焦虑抑郁→术后早期疼痛)相对中介占比31.76%,路径2(术前疼痛灾难化→睡眠质量→术后早期疼痛)相对中介占比15.29%,路径3(术前疼痛灾难化→焦虑抑郁→睡眠质量→术后早期疼痛)相对占比为15.29%。结论术前疼痛灾难化与腹部手术患者早期疼痛有关,睡眠质量和焦虑抑郁可影响术前疼痛灾难化和术后早期疼痛。Objective To explore the mediating effects of sleep quality,anxiety-depression on pain catastrophizing before surgery and early postoperative pain in patients undergoing abdominal surgery.The findings will contribute to the development of intervention programs aimed at reducing early postoperative pain.Methods A total of 206 patients who underwent abdominal surgery at Linping Hospital,the Second Affiliated Hospital of Zhejiang University School of Medicine,from January 2021 to January 2022 were selected for evaluation.The evaluation was conducted using the pain catastrophizing scale(PCS),hospital anxiety and depression scale(HADS),Pittsburgh sleep quality index(PSQI)and visual analog scale(VAS).Pearson correlation analysis was used to investigate the correlation between sleep quality,anxiety-depression in preoperative pain catastrophizing and early postoperative pain in abdominal surgery patients.Additionally,a mediating effect test was conducted.Results A total of 206 questionnaires were distributed,and 192 valid questionnaires were collected,resulting in a response rate of 93.20%.The sample consisted of 104 males and 88 females,with an average age of(54.95±7.89)years.Pearson correlation analysis showed significant positive correlations between preoperative pain catastrophizing and early postoperative pain,anxiety-depression,as well as sleep quality(r=0.813,0.745,0.792,all P<0.001),and early postoperative pain was significantly positively correlated with anxiety-depression and sleep quality(r=0.834,0.842,all P<0.001).The results of the Bootstrap method indicated that the mediating effect value for the three pathways was 0.106,according for 62.35%of the total effect.Specifically,the mediating ratio of path 1(preoperative pain disaster→anxiety-depression→early postoperative pain)was 31.76%,and the mediating ratio of path 2(preoperative pain disaster→sleep quality→early postoperative pain)was 15.29%.Path 3(preoperative pain disaster→anxiety-depression→sleep quality→early postoperative pain)accounted

关 键 词：腹部手术 疼痛灾难化 早期疼痛 睡眠质量 焦虑抑郁 

分 类 号：R656[医药卫生—外科学] R619[医药卫生—临床医学]