松弛疗法及药物治疗对SMILE手术患者术中配合度及预后的影响

The Effects of Relaxation Therapy and Pharmacological Treatment on the Intraoperative Cooperation Degree and Prognosis of Patients Undergoing SMILE Surgery

摘要: 目的：探讨松弛疗法及药物治疗对全飞秒激光小切口基质透镜取出术(Small Incision Lenticule Extraction, SMILE)手术患者术中配合度及预后的影响。方法：采用随机序列法抽取2023年3月~2024年10月期间在青岛爱尔眼科医院屈光手术科行SMILE手术治疗的屈光不正合并术前焦虑的患者为研究对象，共纳入165例，根据治疗方式的不同分为松弛疗法组(55例)、药物治疗组(55例)及对照组(55例)。松弛疗法组术前进行渐进式肌肉放松训练，药物治疗组术前使用奥沙西泮，对照组不做干预。比较三组间血压、心率等应激指标、焦虑自评量表评分、术中配合度、术后视力恢复情况。结果：治疗后，松弛疗法组及药物治疗组焦虑自评量表得分情况、血压、心率均降低，且药物治疗组低于松弛疗法组，差异均有统计学意义(P均 < 0.05)。药物治疗组眼位异常移动次数、并发症数量均少于松弛疗法组，差异均有统计学意义(P均 < 0.05)，两治疗组间中心定位次数、手术时间、术后视力恢复情况差异无统计学意义(P均 > 0.05)，但以上指标均优于对照组，差异均有统计学意义(P均 < 0.05)。结论：松弛疗法及药物治疗均能有效改善SMILE手术患者术前焦虑及应激状态，提高患者的术中配合度及术后视力恢复速度，药物治疗在缓解生理和心理应激方面见效更快、效果更强，但在手术效率和短期视力结局上不优于松弛疗法。

Abstract: Objective: To investigate the effects of relaxation therapy and pharmacological treatments on intraoperative cooperation degree and prognosis in patients undergoing Small Incision Lenticule Extraction (SMILE) surgery. Methods: A total of 165 patients with refractive errors and anxiety who received SMILE surgery at the Refractive Surgery Department of Qingdao Ai’er Eye Hospital from March 2023 to October 2024 were selected using a random sequence method. They were divided into three groups based on treatment modality: a relaxation therapy group (55 cases), a pharmacological treatment group (55 cases), and a control group (55 cases). The relaxation therapy group received progressive muscle relaxation training preoperatively, the pharmacological treatment group was administered oxazepam preoperatively, and the control group received no intervention. Stress indicators such as blood pressure and heart rate, Self-Rating Anxiety Scale (SAS) scores, intraoperative cooperation degree, and postoperative visual acuity recovery were compared among the three groups. Results: After treatment, both the relaxation therapy and pharmacological treatment groups showed decreased SAS scores, blood pressure, and heart rate, with the pharmacological treatment group exhibiting lower values than the relaxation therapy group, indicating statistically significant differences (P < 0.05). The pharmacological treatment group also had fewer instances of abnormal eye movement and complications compared to the relaxation therapy group, with these disparities reaching statistical significance (P < 0.05). There were no statistically significant differences in the number of central positioning times, operation time, and postoperative visual acuity recovery between the two treatment groups (P > 0.05), but these indicators were superior to those in the control group, with statistically significant differences (P < 0.05). Conclusion: Both relaxation therapy and pharmacological treatments can effectively ameliorate preoperative anxiety and stress in SMILE surgery patients, enhancing intraoperative cooperation degree and the rate of postoperative visual acuity recovery. Although pharmacological treatment acts faster and is more potent in relieving physiological and psychological stress, it is not superior to relaxation therapy in terms of surgical efficiency or short-term visual outcomes.