乳腺癌患者术前焦虑的相关因素及血流动力学研究

目的:明确乳腺癌患者术前焦虑的相关因素以及对麻醉管理中血流动力学的影响。方法:评估75例乳腺癌患者术前焦虑状态，根据状态焦虑量表评分（SAI），将患者分为高焦虑组（SAI＞45，n＝16）和低焦虑组（SAI≤45，n＝59），分析术前焦虑相关因素。测量并比较两组患者术前及麻醉管理中的血压、心率差异。结果:乳腺癌患者术前焦虑的产生与手术及麻醉本身、对手术信息的需求有关。术前焦虑趋向于年轻化、既往无全麻史、较长住院时长患者。高焦虑组患者喉罩置入时的收缩压、喉罩拔除时的收缩压及心率明显高于低焦虑组。结论:年龄、既往全麻史、住院时长、对手术本身的担忧是乳腺癌患者术前焦虑的相关因素。术前高焦虑患者在喉罩置入时收缩压高于术前低焦虑患者；术前高焦虑患者在喉罩拔除时收缩压及心率高于术前低焦虑患者。

Assessment of preoperative anxiety in breast cancer patients: contributing factors and hemodynamics.

Objective: To measure the level of preoperative anxiety in patients with breast cancer, identify any influencing clinical factors, and assess the relationship between preoperative anxiety and hemodynamics during anesthesia management. Methods: The study included 75 patients with breast cancer. The level of preoperative anxiety in patients was assessed and patients were divided into two groups according to the State Anxiety Inventory，high-level anxiety(SAI>45, n=16) and low-level anxiety(SAI≤45，n＝59). Factors influencing preoperative anxiety were identified. Patients’ blood pressure and the heart rate measured and compared. Results: The preoperative anxiety was affected by surgery, anesthesia and the requirement of information. The younger patients developed higher anxiety. Patients with hospital stay of several days developed high-level anxiety. The systolic blood pressure after the laryngeal mask insertion in patients with high-level anxiety was significantly higher than patients with low-level anxiety, and the systolic blood pressure and heart rate after the laryngeal mask removal also had the same feature. Conclusion: In patients with breast cancer , both fear of the unknown and lack of information, especially when it is related to the surgery, may be crucial factors in high levels of preoperative anxiety in radical mastectomy. The high-level preoperative anxiety may affect the hemodynamics during anesthesia management.