机械通气前焦虑程度对全身麻醉患者氧化应激及低氧血症的影响  

Effect of Anxiety Before Mechanical Ventilation on Oxidative Stress and Hypoxemia in Patients Under General Anesthesia

作　　者：杨晴[1] 汪孟幻 张抒宇 王嘉宇 向导 信文启[1] Yang Qing;Wang Menghuan;Zhang Shuyu;Wang Jiayu;Xiang Dao;Xin Wenqi(Huaihe Hospital of Henan University,Kaifeng 475000,China)

机构地区：[1]河南大学淮河医院,开封475000

出　　处：《成都医学院学报》2025年第2期299-302,307,共5页Journal of Chengdu Medical College

基　　金：河南省科学技术厅基金项目(No:232102310174)。

摘　　要：目的探究机械通气前焦虑程度对全身麻醉患者氧化应激及低氧血症的影响。方法选取河南大学淮河医院普外科2023年5月至2024年2月收治的200例需行腹腔镜手术治疗的结直肠癌患者作为研究对象,采用焦虑自评量表(SAS)评估患者术前焦虑程度,根据评分结果将患者分为重度焦虑组、轻中度焦虑组和正常组。对比不同程度焦虑患者机械通气后氧化应激指标水平及低氧血症发生情况。根据低氧血症发生情况将患者分为低氧血症组和血氧正常组,对比两组患者临床资料,筛选全身麻醉患者机械通气后发生低氧血症的危险因素。结果SAS量表显示,术前存在重度焦虑的患者有90例,轻中度焦虑的患者68例,心理状态良好的患者42例。低氧血症发生率比较,重度焦虑组46.67%>轻中度焦虑组20.59%>正常组4.76%,差异有统计学意义(P<0.05)。氧化应激指标超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)水平比较,重度焦虑组<轻中度焦虑组<正常组,丙二醛(MDA)水平比较,重度焦虑组>轻中度焦虑组>正常组,差异有统计学意义(P<0.05)。Spearman相关性分析显示,SOD、GSH-Px水平与焦虑程度呈负相关(r=-0.5523、-0.3171,P<0.001),MDA水平与焦虑程度呈正相关(r=0.6010,P<0.001)。Logistic回归分析结果显示,体重指数(BMI)、吸烟史、慢性阻塞性肺疾病(COPD)、术前焦虑程度是全身麻醉患者机械通气后发生低氧血症的影响因素(P<0.05)。结论机械通气前焦虑程度与围术期氧化应激指标水平变化存在相关性,焦虑是围术期发生低氧血症的独立危险因素。Objective To explore the effects of different anxiety levels before mechanical ventilation on the oxidative stress and hypoxemia in patients under general anesthesia.Methods A total of 200 patients with colorectal cancer who needed laparoscopic surgery were selected from the Department of General Surgery,Huaihe Hospital of Henan University from May 2023 to February 2024.The patients were divided into a severe anxiety group,a mild to moderate anxiety group and a normal group according to their preoperative anxiety level assessed by Self-rating Anxiety Scale(SAS).The levels of oxidative stress indicators and the incidence of hypoxemia after mechanical ventilation in patients with different degrees of anxiety were compared.And the patients were divided into a hypoxemia group and a normal blood oxygen group according to the occurrence or absence of hypoxemia.The clinical data of the two groups were compared to screen out the risk factors for the occurrence of hypoxemia after mechanical ventilation in patients under general anesthesia.Results SAS showed that there were 90(45.00%)patients with severe anxiety,68(34.00%)patients with mild to moderate anxiety,and 42(21.00%)patients with good mental state.The incidence of hypoxemia in the severe anxiety group was 46.67%(42/90),higher than 20.59%(14/68)in the mild to moderate anxiety group,which was in turn higher than 4.76%(2/42)in the normal group,and the differences were statistically significant(P<0.05).The levels of oxidative stress indicators superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px)in the severe anxiety group were lower than those in the mild to moderate anxiety group,which were in turn lower than those in the normal group,while the level of malondialdehyde(MDA)in the severe anxiety group was higher than that in the mild to moderate anxiety group,which was in turn higher than that in the normal group,and the differences were statistically significant(P<0.05).Spearman correlation analysis revealed a negative correlation between the levels of SOD and

关 键 词：机械通气 焦虑程度 全身麻醉 氧化应激 低氧血症 

分 类 号：R716.5[医药卫生—妇产科学]