非心脏手术患者术前焦虑对术后睡眠质量影响的研究进展

Research Progress on the Impact of Preoperative Anxiety on Postoperative Sleep Quality in Patients Undergoing Non-Cardiac Surgery

摘要: 非心脏手术患者术前焦虑与术后睡眠质量的关系已成为围手术期管理的重要课题。研究表明，30%~80%的患者存在术前焦虑，其通过心理和生理双重机制影响术后睡眠：心理上增强疼痛敏感性，生理上干扰睡眠结构(如阿片类药物使REM睡眠减少40%~60%)。干预方面，非药物方法如正念减压(MBSR)可显著改善睡眠质量，而多模式预康复方案效果更佳。但苯二氮䓬类药物可能加重睡眠障碍。当前研究存在方法学局限和个体化干预不足等问题。未来需开展大样本研究，开发基于生物标志物的预测模型和智能干预系统，这对优化围手术期管理具有重要意义。

Abstract: The relationship between preoperative anxiety and postoperative sleep quality in patients undergoing non-cardiac surgery has become an important topic in perioperative management. Studies have shown that 30% to 80% of patients experience preoperative anxiety, which affects postoperative sleep through both psychological and physiological mechanisms: psychologically, it enhances pain sensitivity; physiologically, it interferes with sleep structure (for instance, opioid drugs reduce REM sleep by 40% to 60%). In terms of intervention, non-pharmaceutical methods such as mindfulness-based Stress reduction (MBSR) can significantly improve sleep quality, while multimodal pre-rehabilitation programs are even more effective. However, benzodiazepines may aggravate sleep disorders. The current research has problems such as methodological limitations and insufficient individualized intervention. In the future, large-scale sample studies need to be conducted, and biomarker-based prediction models and intelligent intervention systems should be developed, which is of great significance for optimizing perioperative management.