术前焦虑情绪对老年全身麻醉乳腺癌根治术中体温及切口愈合的影响研究
Effects of preoperative anxiety on intraoperative body temperature and incision healing in radical mastectomy under general anesthesia in the elderly
杨玉春 1吴皎卿 1梁婷婷 1胡玉萍 1戴体俊2
作者信息
- 1. 南京医科大学第四附属医院麻醉科,江苏 南京 210031
- 2. 徐州医科大学麻醉药理学教研室,江苏 徐州 221004
- 折叠
摘要
目的 探究术前焦虑情绪对全身麻醉下行乳腺癌根治术的老年患者术中体温、苏醒期不良反应及切口愈合情况的影响.方法 选取2020年1月至2022年12月南京医科大学第四附属医院收治的139例于全身麻醉下行乳腺癌根治术的老年患者为研究对象,根据术前是否合并焦虑情绪分为无焦虑组(87例)和焦虑组(52例).比较2组患者术前、手术30 min、手术60 min、手术90 min及手术结束时的鼻咽温度、术中鼻咽温度<36.0℃比例、围术期出血量>300 mL比例、苏醒期不良反应发生情况及切口愈合情况.结果 2组患者术前及手术30 min时的鼻咽温度比较,差异无统计学意义(P>0.05);在手术60 min、手术90 min及手术结束时,焦虑组患者的鼻咽温度均低于无焦虑组,差异有统计学意义(P<0.05);2组患者组内不同时刻的鼻咽温度比较,差异均有统计学意义(P<0.05).焦虑组术中鼻咽温度<36.0℃及围术期出血量>300 mL的患者比例均高于无焦虑组,差异有统计学意义(P<0.05).焦虑组苏醒延迟、寒战反应的发生率及术后切口愈合不良的发生率均高于无焦虑组,差异有统计学意义(P<0.05).结论 术前合并焦虑情绪的全身麻醉下乳腺癌根治术老年患者从手术60 min开始出现明显的体温下降,围术期出血量明显增加,术中低体温、苏醒期不良反应及术后切口愈合不良发生率更高,应引起临床关注.
Abstract
Objective To explore the effects of preoperative anxiety on intraoperative body temperature,adverse reactions during recovery and incision healing in elderly patients undergoing radical mastectomy under general anesthesia.Methods A total of 139 elderly patients who underwent radical mastectomy under general anesthesia in the Fourth Affiliated Hospital of Nanjing Medical University from January 2020 to December 2022 were selected as the study objects,and they were divided into the non-anxiety group(87 cases)and the anxiety group(52 cases)according to whether they were complicated with anxiety before surgery.The nasopharyngeal temperature before surgery,after 30 minutes,60 minutes,90 minutes of surgery and at the end of surgery,the ratio of intraoperative nasopharyngeal temperature<36.0℃,the ratio of perioperative blood loss>300 mL,the occurrence of adverse reactions during the recovery period and the incision healing of patients in the two groups were compared.Results There was no statistically significant difference in the nasopharyngeal temperature before surgery and after 30 minutes of surgery of patients between the two groups(P>0.05).After 60 minutes,90 minutes of surgery and the end of surgery,the nasopharyngeal temperatures of patients in the anxiety group were lower than those in the non-anxietey group,and the differences were statistically significant(P<0.05).There were statistically significant differences in the nasopharyngeal temperature at different times of patients in the two groups(P<0.05).The ratios of patients with intraoperative nasopharyngeal temperature<36.0℃and perioperative blood loss>300 mL in the anxiety group were higher than those in the non-anxiety group,and the differences were statistically significant(P<0.05).The incidence of delayed awakening,shivering reaction,and poor postoperative incision healing in the anxiety group were higher than those in the non-anxiety group,with statistically significant differences(P<0.05).Conclusion Elderly patients undergoing radical mastectomy under general anesthesia combined with anxiety show obvious temperature drop after 60 minutes of surgery,and perioperative blood loss has significantly increased,with a higher incidence of intraoperative hypothermia,adverse reactions during recovery and poor postoperative incision healing,which should arouse clinical attention.
关键词
焦虑情绪/全身麻醉/乳腺癌根治术/术中低体温/切口/不良反应Key words
anxiety emotions/general anesthesia/radical mastectomy/intraoperative hypothermia/incision/adverse reactions引用本文复制引用
基金项目
国家自然科学基金(30872432)
南京市卫生科技发展项目(YKK20250)
出版年
2024
国家科技期刊平台
NSTL
万方数据