神经外科患者术前担忧问题调查

目的观察神经外科术前患者担忧的问题及其程度,并分析其相关原因。方法选择18~80岁神经外科择期手术患者112例,询问有关围手术期担忧问题并进行评分,将担忧问题的相关原因进行分类评分。结果 60岁以上患者对手术的预后、功能恢复、出血和切口外观的担忧程度下降,但对苏醒时间、智力受损、术中疼痛、术中知晓、术后疼痛、耐受力、插管风险和花费的担忧程度增加。女性对肿瘤的全切、复发、切口外观方面担忧较大,但对智力受损、副作用、耐受性则低于男性。无手术史者各方面担忧程度更高,有合并症患者在术中疼痛、术中知晓、耐受力、穿刺困难等方面更为担忧（P〈0.05）。患者的担忧原因,排在第一位的是手术麻醉效果（4.54±0.28）,其次为知识缺乏（3.93±0.20）、风险担心（3.87±0.30）、舒适度与满意度（3.74±0.41）和社会因素（2.21±0.47）。结论不同年龄、性别、职业及有无手术史和合并症的神经外科患者术前担忧问题差异较大,应有针对性地进行相关知识的健康教育,完善术前访视,提高服务质量,最大限度的减少患者术前担忧的问题及减轻担忧程度。

Investigation on preoperative concerns of neurosurgical patients

Objective To observe and analyze the preoperative concerns of neurosurgical patients.Methods 112 patients,18-80 years old,were enrolled and questioned about the preoperative concerns.The scores were recorded and analyzed. Results As for age,patients older than 60 showed less concerns about outcomes,function,bleeding,and appearance of incision,but more about recovery time,impairment of IQ,pain,awareness,tolerance,risk of intubation and expenses.Women concerned more on tumor full resection,recurrent and appearance of incision,but less on impairment of IQ,side effects and tolerance.To all the patients,the major reason of the concerns was the unexpected results of surgery and anesthesia（4.54±0.28）,medical knowledge insufficient（3.93±0.20）,risks（3.87±0.30）,patients satisfaction（3.74±0.41）,and social factors（2.21±0.47）.Conclusion Patients of different age,sex,education background with or without history of surgery and complication varies greatly on preoperative concerns.Preoperative visits and education should be improved to reduce these concerns.