术前焦虑情绪对老年全身麻醉腹腔镜下子宫切除术的影响  

Effect of preoperative anxiety on laparoscopic hysterectomy under general anesthesia in the elderly

作　　者：仇晶辉 戴慧荣 吉林[1] 袁从虎[1] 王涛 戴体俊 QIU Jing-hui;DAI Hui-rong;JI Lin;YUAN Cong-hu;WANG Tao;DAI Ti-jun(Department of Anesthesiology,Yancheng Third People's Hospital,Yancheng Jiangsu 224000,China;Department of Anesthesiology and Pharmacology,Xuzhou Medical University,Xuzhou Jiangsu 221004,China)

机构地区：[1]盐城市第三人民医院麻醉科,江苏盐城224000 [2]徐州医科大学麻醉药理学教研室,江苏徐州221004

出　　处：《局解手术学杂志》2025年第3期228-231,共4页Journal of Regional Anatomy and Operative Surgery

基　　金：国家自然科学基金(30872432)。

摘　　要：目的明确术前焦虑情绪对全身麻醉腹腔镜下子宫切除老年患者术中体温、隐性失血量和切口愈合的影响。方法选择2021年1月至2023年12月在盐城市第三人民医院行腹腔镜下子宫切除的118例老年患者为研究对象,根据术前1 d焦虑自评量表(SAS)评分分为正常组(情绪正常,69例)和焦虑组(焦虑情绪,49例)。比较2组患者不同时点的核心温度以及术中低体温发生情况;比较2组患者的术中出血量、切口引流血量、隐性失血量、不良反应发生情况及切口愈合情况。结果焦虑组患者手术60 min和手术结束时的核心温度明显低于正常组(P<0.05)。焦虑组患者的术中低体温发生率明显高于正常组(P<0.05)。2组患者术中出血量和切口引流血量比较差异无统计学意义(P>0.05),而焦虑组患者的隐性失血量明显多于正常组(P<0.05)。焦虑组患者的寒战发生率明显高于正常组(P<0.05);焦虑组患者的切口愈合不良率明显高于正常组(P<0.05)。结论对于行腹腔镜下子宫切除手术且时间超过60 min的老年患者,若术前有焦虑情绪术中体温会显著降低,术中低体温和寒战发生率较高,隐性失血量显著增加,容易发生切口愈合不良,不利于患者术后快速康复。Objective To investigate the effects of preoperative anxiety on the intraoperative body temperature,recessive blood loss,and wound healing in elderly patients undergoing laparoscopic hysterectomy under general anesthesia.Methods A total of 118 elderly patients who underwent laparoscopic hysterectomy in Yancheng Third People's Hospital from January 2021 to December 2023 were selected as the research subjects,and they were divided into the normal group(69 cases with normal emotions)and the anxiety group(49 cases with anxiety emotions)according to the self-rating anxiety scale(SAS)score 1 day before operation.The core temperature at different time points and the incidence of intraoperative hypothermia were compared between the two groups.The intraoperative bleeding volume,incision drainage bleeding volume,recessive blood loss,incidence of adverse reactions,and wound healing were compared between the two groups.Results The core temperature 60 minutes after operation and at the end of operation in the anxiety group were significantly lower than those in the normal group(P<0.05).The incidence of intraoperative hypothermia in the anxiety group was significantly higher than that in the normal group(P<0.05).There was no statistically significant difference in the intraoperative bleeding volume or incision drainage bleeding volume between the two groups(P>0.05),while the recessive blood loss in the anxiety group was significantly higher than that in the normal group(P<0.05).The incidence of shivering in the anxiety group was significantly higher than that in the normal group(P<0.05);the incidence of poor wound healing in the anxiety group was significantly higher than that in the normal group(P<0.05).Conclusion For elderly patients who undergo laparoscopic hysterectomy for more than 60 minutes,the body temperature will significantly decrease,the incidence of intraoperative hypothermia and shivering is high,the recessive blood loss will significantly increase,which is prone to poor wound healing and is not conducive to the

关 键 词：焦虑 腹腔镜下子宫切除 老年 体温 隐性失血量 切口愈合 

分 类 号：R614[医药卫生—麻醉学]