围术期患者焦虑抑郁状态调查及其影响因素分析

目的 调查行全身麻醉患者围术期焦虑抑郁发生情况及其影响因素.方法 选择北京大学第一医院2006年6-8月于全麻或全麻复合硬膜外麻醉择期手术的100例患者,于术前1 d及术后5～10 d访视,记录人口学及临床资料,嘱患者填写医院焦虑抑郁调查量表(hospital anxiety anddepression scale,HADS).结果 术前分别有23%,20%的患者存在焦虑、抑郁,术后分别为17%、16%.与术前焦虑相关因素为合并抑郁(P<0.01)及中等(P<0.05)或高等(P<0.05)教育程度;与术前抑郁相关因素为合并焦虑(P<0.01);与术后焦虑相关因素为术前焦虑(P<0.01),术后合并抑郁(P<0.01)及低或中等教育程度(P<0.05);与术后抑郁相关因素为女性(P<0.05)、术前抑郁(P<0.01)、术后合并焦虑(P<0.05)及术后咽部不适感(P<0.05).结论 围术期患者可存在焦虑抑郁状态,两种负性情绪之间有明显相互影响,教育程度、性别和术后咽部不适感也可分别对围术期的情绪状态产生影响.

Incidence of peri-operative anxiety and depression in patients and of risk factors

Objective Our study investigate the peri-operative incidence of depression and anxiety of patients undergoing general anesthesia, and assesses the relationship between peri-operative characteristics with anxiety and depression. Methods Demographic, clinical data and HADS score were collected before and after surgery. Analysis all the data with SPSS 10.3. Results Anxiety was found pre- and post-operative in 23% and 17% of patients respectively while the rate of depression was 20% and 16% respectively. Middle or high-level (P<0.05) education was associated with pre-operative anxiety; Pre-operative anxiety and depression are interactional (P<0.01). Post-operative depression (P<0.01) predicted post-operative anxiety; female(P<0.05), pre-operative depression, post-operative anxiety (P<0.05) and discomfort of pharynx(P<0.05) predicted post-operative depression. Conclusions Patients may experience anxiety or depression during peri-oporation. Anxiety and depression are interactional. Level of education, sex and discomfort of pharynx may influence pre- or post-operative anxiety or depression respectively.