普外科手术患者术前焦虑评估与心理护理干预研究综述

A Review of Preoperative Anxiety Assessment and Psychological Nursing Interventions in Patients Undergoing General Surgery

摘要: 普外科涵盖肝胆、胃肠、甲状腺、乳腺等多类型择期与急诊手术，患者术前焦虑发生率长期维持在45%~72%，过度焦虑会激活下丘脑–垂体–肾上腺(HPA)轴，引发血流动力学波动、免疫抑制、术后疼痛敏化及胃肠功能恢复延迟，直接提升围术期不良事件风险。本文梳理了国内外普外科围术期心理护理相关文献，总结术前焦虑病理生理机制、主客观评估工具适用场景、主流心理护理干预模式的循证证据，剖析现有研究与临床落地的矛盾，提出基于风险分层的精准心理护理实施路径，为普外科围术期优质护理规范化开展提供循证依据。

Abstract: General surgery encompasses a wide range of elective and emergency procedures involving the liver, biliary tract, gastrointestinal system, thyroid, and breast. The prevalence of preoperative anxiety among patients has long remained between 45% and 72%. Excessive anxiety can activate the hypothalamic-pituitary-adrenal (HPA) axis, leading to hemodynamic fluctuations, immune suppression, heightened postoperative pain sensitivity, delayed gastrointestinal function recovery, and thereby directly increasing the risk of perioperative adverse events. This article reviews domestic and international literature on perioperative psychological care in general surgery, summarizes the pathophysiological mechanisms of preoperative anxiety, appropriate applications of subjective and objective assessment tools, and evidence-based support for mainstream psychological interventions. It analyzes the discrepancies between current research and clinical implementation, and proposes a precision-based psychological care pathway grounded in risk stratification, providing an evidence-based foundation for standardized, high-quality perioperative nursing in general surgery.