剖宫产手术患者术前焦虑评估及干预措施研究进展
Research Progress of Preoperative Anxiety Assessment and Intervention Measures for Patients Undergoing Cesarean Section
DOI: 10.12677/ACM.2022.126844, PDF,    科研立项经费支持
作者: 李 桃:大理大学,云南 大理;李 艳:保山市人民医院麻醉科,云南 保山;金 华*:云南省第一人民医院麻醉科,云南 昆明
关键词: 剖宫产术前焦虑术前焦虑评估量表经皮穴位低频电刺激(TEAS)正念冥想(MM)Cesarean Section Preoperative Anxiety Preoperative Anxiety Assessment Scale Transcutaneous Electrical Acupoint Stimulatio (TEAS) Mindfulness Meditation (MM)
摘要: 术前焦虑是手术患者普遍存在的一种负面情绪,剖宫产手术患者在术前存在不同程度的焦虑情绪,术前焦虑可能导致麻醉药物用量增加,围术期血流动力学不稳定、术后疼痛、恶心、呕吐、睡眠障碍等相关并发症发生率增加,影响患者术后康复并降低就医体验,因此,患者术前心理状态尤为重要。本文就术前焦虑的危害性、临床常用心理评估量表及不同干预措施的效果等进行综述,以便更好地精准评估患者术前心理状态,并及时分析患者术前焦虑因素,为制定出个体化的干预措施缓解患者术前焦虑提供思路。
Abstract: Preoperative anxiety is common in patients with a negative emotion, cesarean section surgery pa-tients in the presence of different degrees of the preoperative anxiety, preoperative anxiety may lead to increased dosage of narcotic drugs, increased incidence of perioperative hemodynamic in-stability, postoperative pain, nausea, vomiting, sleep disorders and other related complications, which may affect patients’ postoperative recovery and reduce their medical experience, therefore, preoperative psychological state of patients is particularly important. In this paper, the harm of preoperative anxiety, clinical commonly used psychological assessment scale and the effect of dif-ferent intervention measures were reviewed, so as to better accurately assess the preoperative psychological state of patients, and timely analyze the preoperative anxiety factors of patients, and provide ideas for the development of individualized intervention measures to relieve patients’ preoperative anxiety.
文章引用:李桃, 李艳, 金华. 剖宫产手术患者术前焦虑评估及干预措施研究进展[J]. 临床医学进展, 2022, 12(6): 5837-5844. https://doi.org/10.12677/ACM.2022.126844

参考文献

[1] Platto, J.F., Maarouf, M., Hendricks, A., Kurtzman, D.J. and Shi, V.Y. (2019) Animated Video Consultation for Reduc-ing Pre-Operative Anxiety in Dermatologic Surgery. Dermatology Online Journal, 25, Article No. 13030. [Google Scholar] [CrossRef
[2] Caumo, W., Schmidt, A.P., Schneider, C.N., Bergmann, J., Iwamoto, C.W., Bandeira, D., et al. (2001) Risk Factors for Preoperative Anxiety in Adults. Acta Anaesthesiologica Scandinavica, 45, 298-307. [Google Scholar] [CrossRef] [PubMed]
[3] 王珊珊, 丁浩, 薛梅. 手术室心理护理对剖宫产患者术前焦虑及满意度的影响评价[J]. 中国医药指南, 2020, 18(33): 187-188.
[4] 赵小玉, 黄琼, 曾理, 张立. 剖宫产术患者焦虑的心理评估及护理干预[J]. 中华现代护理杂志, 2007, 13(15): 1395-1396.
[5] 姚宗良, 辛志峰. 围手术期剖宫产妇女心理状况及心理干预效果[J]. 中国心理卫生杂志, 2008, 22(2): 137-140.
[6] Hobson, J.A., Slade, P., Wrench, I.J. and Power, L. (2006) Preoperative Anxiety and Postoperative Satisfaction in Women Undergoing Elective Caesarean Section. International Journal of Obstetric Anesthesia, 15, 18-23. [Google Scholar] [CrossRef] [PubMed]
[7] D’souza, R. and Arulkumaran, S. (2013) To “C” or Not to “C”? Caesarean Delivery upon Maternal Request: A Review of Facts, Figures and Guidelines. Journal of Perinatal Medicine, 41, 5-15. [Google Scholar] [CrossRef] [PubMed]
[8] Rashid, A. and Riaz, M.N. (2021) Impact of Preoperative Surgical Anxiety on Postoperative Surgical Recovery among Surgical Patients: Role of Surgical Coping. Journal of Paki-stan Medical Association, 71, 2313-2316. [Google Scholar] [CrossRef
[9] Kim, W.S., Byeon, G.J., Song, B.J. and Lee, H.J. (2010) Availability of Preoperative Anxiety Scale as a Predictive Factor for Hemodynamic Changes during Induction of Anesthesia. Korean Journal of Anesthesiology, 58, 328-333. [Google Scholar] [CrossRef] [PubMed]
[10] Pittman, S. and Kridli, S. (2011) Music Intervention and Preopera-tive Anxiety: An Integrative Review. International Nursing Review, 58, 157-163. [Google Scholar] [CrossRef] [PubMed]
[11] Matthias, A.T. and Samarasekera, D.N. (2012) Preopera-tive Anxiety in Surgical Patients—Experience of a Single Unit. Acta Anaesthesiologica Taiwanica, 50, 3-6. [Google Scholar] [CrossRef] [PubMed]
[12] Navarro-Gaston, D. and Munuera-Martinez, P.V. (2020) Prevalence of Preoperative Anxiety and Its Relationship with Postoperative Pain in Foot Nail Surgery: A Cross-Sectional Study. In-ternational Journal of Environmental Research and Public Health, 17, Article No. 4481. [Google Scholar] [CrossRef] [PubMed]
[13] Che, Y.J., Gao, Y.L., Jing, J., Kuang, Y. and Zhang, M. (2020) Ef-fects of an Informational Video about Anesthesia on Pre- and Post-Elective Cesarean Section Anxiety and Recovery: A Randomized Controlled Trial. Medical Science Monitor, 26, e920428. [Google Scholar] [CrossRef
[14] Sahin, T., Gulec, E., Sarac Ahrazoglu, M. and Tetiker, S. (2016) As-sociation between Preoperative Maternal Anxiety and Neonatal Outcomes: A Prospective Observational Study. Journal of Clinical Anesthesia, 33, 123-126. [Google Scholar] [CrossRef] [PubMed]
[15] Dunstan, D.A. and Scott, N. (2020) Norms for Zung’s Self-Rating Anxiety Scale. BMC Psychiatry, 20, Article No. 90. [Google Scholar] [CrossRef] [PubMed]
[16] Yue, T., Li, Q., Wang, R., Liu, Z., Guo, M., Bai, F., et al. (2020) Comparison of Hospital Anxiety and Depression Scale (HADS) and Zung Self-Rating Anxiety/Depression Scale (SAS/SDS) in Evaluating Anxiety and Depression in Patients with Psoriatic Arthritis. Dermatology, 236, 170-178. [Google Scholar] [CrossRef] [PubMed]
[17] Vergara-Romero, M., Morales-Asencio, J.M., Morales-Fernandez, A., Canca-Sanchez, J.C., Rivas-Ruiz, F. and Reinaldo-Lapuerta, J.A. (2017) Validation of the Spanish Version of the Am-sterdam Preoperative Anxiety and Information Scale (APAIS). Health and Quality of Life Outcomes, 15, Article No. 120. [Google Scholar] [CrossRef] [PubMed]
[18] Maurice-Szamburski, A., Loundou, A., Capdevila, X., Bruder, N. and Auquier, P. (2013) Validation of the French Version of the Amsterdam Preoperative Anxiety and Information Scale (APAIS). Health and Quality of Life Outcomes, 11, Article No. 166. [Google Scholar] [CrossRef] [PubMed]
[19] Wu, H., Zhao, X., Chu, S., Xu, F., Song, J., Ma, Z., et al. (2020) Validation of the Chinese Version of the Amsterdam Preoperative Anxiety and Information Scale (APAIS). Health and Quality of Life Outcomes, 18, Article No. 66. [Google Scholar] [CrossRef] [PubMed]
[20] Julian, L.J. (2011) Measures of Anxiety: State-Trait Anxiety In-ventory (STAI), Beck Anxiety Inventory (BAI), and Hospital Anxiety and Depression Scale-Anxiety (HADS-A). Ar-thritis Care & Research, 63, S467-S472. [Google Scholar] [CrossRef] [PubMed]
[21] Guillen-Riquelme, A. and Buela-Casal, G. (2014) Meta-Analysis of Group Comparison and Meta-Analysis of Reliability Generalization of the State-Trait Anxiety Inventory Questionnaire (STAI). Revista Española de Salud Pública, 88, 101-112. [Google Scholar] [CrossRef
[22] Taylor, J.A. (1953) A Personality Scale of Manifest Anxiety. The Journal of Abnormal and Social Psychology, 48, 285-290. [Google Scholar] [CrossRef] [PubMed]
[23] Kabacoff, R.I., Segal, D.L., Hersen, M. and Van Hasselt, V.B. (1997) Psy-chometric Properties and Diagnostic Utility of the Beck Anxiety Inventory and the State-Trait Anxiety Inventory with Older Adult Psychiatric Outpatients. Journal of Anxiety Disorders, 11, 33-47. [Google Scholar] [CrossRef
[24] Kruyen, P.M., Emons, W.H. and Sijtsma, K. (2013) Short-ening the S-STAI: Consequences for Research and Clinical Practice. Journal of Psychosomatic Research, 75, 167-172. [Google Scholar] [CrossRef] [PubMed]
[25] 姚玮, 左媛, 贾黎英, 戴姜, 戴媛, 于雪娟. 不同护理干预方案对剖宫产术等候期产妇焦虑情绪的影响[J]. 山西医药杂志, 2016, 45(19): 2313-2315.
[26] 晁敏, 梁丰, 王尊, 王磊, 王旭东. 经皮穴位电刺激在慢性病中的临床应用研究进展[J]. 中国康复医学杂志, 2016, 31(6): 710-714.
[27] Qu, F., Li, R., Sun, W., Lin, G., Zhang, R., Yang, J., et al. (2017) Use of Electroacupuncture and Transcutaneous Electrical Acupoint Stimulation in Reproductive Medicine: A Group Consensus. Journal of Zhejiang University-SCIENCE B, 18, 186-193. [Google Scholar] [CrossRef
[28] Chen, J., Tu, Q., Miao, S., Zhou, Z. and Hu, S. (2020) Transcutaneous Electrical Acupoint Stimulation for Preventing Postoperative Nausea and Vomiting after General Anesthesia: A Meta-Analysis of Randomized Controlled Trials. International Journal of Surgery, 73, 57-64. [Google Scholar] [CrossRef] [PubMed]
[29] 何孟霖, 胡澄, 田伟千. 经皮穴位电刺激在围手术期的应用[J]. 针刺研究, 2021, 46(9): 800-803.
[30] 王燕, 齐慧, 曹春玲, 代春阳, 李静, 蒋娟. 自控经皮电刺激耳神门穴对妇科手术患者术前焦虑情绪及静脉穿刺置管时疼痛评分的影响[J]. 国际护理学杂志, 2014, 33(8): 2224-2226.
[31] 李井柱, 郑丽莉, 王明山, 刘玉秋, 时飞, 毕燕琳, 等. 自控经皮电刺激耳神门穴对剖宫产术中镇静的有效性及安全性观察[J]. 中国中西医结合杂志, 2012, 32(7): 885-888.
[32] Dowswell, T., Bedwell, C., Lavender, T. and Neilson, J.P. (2009) Transcutaneous Electrical Nerve Stimulation (TENS) for Pain Relief in Labour. Cochrane Database of Systematic Reviews, No. 2, Article ID: CD007214. [Google Scholar] [CrossRef
[33] 吴小凤. 经皮穴位电刺激干预家兔正畸牙痛的作用及对脑脊液β-EP、5-HT影响的研究[D]: [硕士学位论文]. 贵阳: 贵阳中医学院, 2013.
[34] 王玥, 李娟. 经皮穴位电刺激缓解围手术期焦虑的临床应用[J]. 国际麻醉学与复苏杂志, 2021, 42(5): 523-526.
[35] 曹莉, 陈振华, 杨建新, 丁仲诺, 孟治寿. 经皮穴位电刺激预处理治疗老年全髋关节置换术后谵妄的临床研究[J]. 中西医结合心脑血管病杂志, 2022, 20(2): 348-352.
[36] 赵燕鹏. 不同频率经皮穴位电刺激对全身麻醉下甲状腺手术术后快速康复的影响[D]: [硕士学位论文]. 承德: 承德医学院, 2021.
[37] 王玥, 黄祥, 杨春梅, 康芳, 李娟. 经皮穴位电刺激对乳腺癌改良根治术患者焦虑的影响[J]. 中华麻醉学杂志, 2020, 40(12): 1431-1435.
[38] 王雪娇. 不同穴位配伍的经皮穴位电刺激在腹腔镜胆囊切除术中的作用[D]: [硕士学位论文]. 张家口: 河北北方学院, 2020.
[39] 唐有为, 陈淑红. 针刺对中枢神经系统功能的影响[J]. 国外医学(中医中药分册), 1997(2): 55-56.
[40] 李胜. 不同强度经皮穴位电刺激对膝关节置换术后镇痛效果的临床观察[D]: [硕士学位论文]. 济南: 山东中医药大学, 2021.
[41] Wang, X., Ding, R., Song, Y., Wang, J., Zhang, C., Han, S., et al. (2020) Transcutaneous Electrical Acu-point Stimulation in Early Life Changes Synaptic Plasticity and Improves Symptoms in a Valproic Acid-Induced Rat Model of Autism. Neural Plasticity, 2020, Article ID: 8832694. [Google Scholar] [CrossRef] [PubMed]
[42] Kim, H.W., Uh, D.K., Yoon, S.Y., Roh, D.H., Kwon, Y.B., Han, H.J., et al. (2008) Low-Frequency Electroacupuncture Sup-presses Carrageenan-Induced Paw Inflammation in Mice via Sympathetic Post-Ganglionic Neurons, While High-Frequency EA Suppression Is Mediated by the Sympathoadrenal Medullary Axis. Brain Research Bulletin, 75, 698-705. [Google Scholar] [CrossRef] [PubMed]
[43] Li, M., Xing, X., Yao, L., Li, X., He, W., Wang, M., et al. (2019) Acupuncture for Treatment of Anxiety, an Overview of Systematic Reviews. Complementary Therapies in Medicine, 43, 247-252. [Google Scholar] [CrossRef] [PubMed]
[44] 李琳, 刘颖, 袁琳, 张锦, 杜丛研. 正念冥想对妇科肿瘤手术患者应激反应的影响[J]. 现代生物医学进展, 2015, 15(16): 3129-3131.
[45] 文庆娟. 心理引导结合正念冥想训练对普外科手术患者心理应激反应和生活质量的影响[J]. 中国健康心理学杂志, 2018, 26(7): 1052-1056.
[46] Hilton, L., Hempel, S., Ewing, B.A., Apaydin, E., Xenakis, L., Newberry, S., et al. (2017) Mindfulness Meditation for Chronic Pain: Systematic Review and Meta-Analysis. Annals of Behavioral Medicine, 51, 199-213. [Google Scholar] [CrossRef] [PubMed]
[47] 杨磊, 王轩久, 刘伟, 石艳波. 正念减压疗法对前列腺癌手术患者睡眠的影响[J]. 世界睡眠医学杂志, 2018, 5(1): 70-74.
[48] Simkin, D.R. and Black, N.B. (2014) Meditation and Mindfulness in Clinical Practice. Child and Adolescent Psychiatric Clinics of North America, 23, 487-534. [Google Scholar] [CrossRef] [PubMed]