心理干预可缓解局麻下椎间孔镜手术患者的术前焦虑

目的探讨心理干预对局麻下椎间孔镜手术患者术前焦虑的影响。方法回顾分析2016年1月~2018年12月间使用阿姆斯特丹术前焦虑与信息量表（APAIS）进行术前焦虑评分、接受局麻经皮椎间孔镜髓核摘除术（PTED）治疗患者的临床资料。将符合纳入标准的患者根据是否接受术前心理干预分为对照组、干预组，比较两组间不同时间点APAIS评分、VAS评分、收缩压、出血量、手术时间等，分析心理干预对患者术前焦虑程度及手术的影响。结果共纳入患者128例，对照组69例，干预组59例。干预组患者准备间APAIS评分（11.83±1.49）比入院时（14.12±1.83）明显下降（P=0.000），对照组患者准备间APAIS评分（13.77±1.59）与入院时（14.22±2.03）相比差异无统计学意义（P=0.150）。干预组患者准备间APAIS评分（11.83±1.49）低于对照组（13.77±1.59），差异有统计学意义（P=0.000）。对照组患者准备间收缩压、术中收缩压、出血量、手术时间均高于干预组（P<0.005）。两组之间术后VAS评分、术中是否加用镇痛药物差异无统计学意义（P>0.05）。结论心理干预可以明显缓解患者术前焦虑，减少椎间孔镜手术出血量、缩短手术时间。 

Effect of psychological intervention on preoperative anxiety in patients with percutaneous transforaminal endoscopic discectomy

Objective To explore the effect of psychological intervention on preoperative anxiety in patients with percutaneous transforaminal endoscopic discectomy(PTED). Methods The clinical data of patients with preoperative anxiety score and PTED under local anesthesia between January 2016 and December 2018 were analyzed retrospectively. Patients who met the inclusion criteria were divided into control group and intervention group according to whether they received preoperative psychological intervention. Different time points of APAIS score, VAS score, systolic blood pressure(SBP), amount of bleeding and operation time were compared between the two groups. The influence of psychological intervention on preoperative anxiety and operation related parameters was analyzed. Results One hundred and twenty-eight patients were included, 69 in the control group and 59 in the intervention group. The APAIS score of the intervention group at waiting room(11.83 ± 1.49)was significantly lower than that at admission(14.12 ± 1.83, P=0.000). There was no significant difference in APAIS score of the control group between at waiting room(13.77 ± 1.59) and the admission(14.22 ± 2.03,P = 0.150). The APAIS score of the intervention group at waiting room(11.83 ± 1.49) was lower than that of the control group(13.77 ± 1.59), the difference was significant(P=0.000). The SBP at waiting room, intraoperative SBP, amount of bleeding and operation time of the control group were higher than those of the intervention group(P<0.005). There was no significant difference in postoperative VAS score,extra analgesic between the two groups(P>0.05). Conclusion Psychological intervention can relieve preoperative anxiety,reduce the amount of bleeding, and shorten the operation time.