[1]王 辉,李永伟.定量分析焦虑和抑郁对截肢病人术后伤口愈合的影响[J].陕西医学杂志,2019,(6):762-765,769.
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定量分析焦虑和抑郁对截肢病人术后伤口愈合的影响
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2019年6期
页码:
762-765,769
栏目:
临床研究
出版日期:
2019-06-05

文章信息/Info

文章编号:
DOI:〖HT5K〗10.3969/j.issn.1000-7377.2019.06.022
作者:
王 辉1 李永伟
1.陕西省友谊医院骨科(西安 710068);2.空军军医大学唐都医院骨四科(西安710038)
关键词:
截肢压力焦虑抑郁伤口愈合心理学
分类号:
R685
文献标志码:
A
摘要:
摘 要 〖HT5K〗目的:通过对截肢病人心理状态的评估及伤口愈合相关参数测量,探讨心理状态对截肢术后病人伤口愈合的影响。方法:收集因血管病变、糖尿病足等拟行单侧小腿中上段截肢患者45例,术前1周行知觉压力量表(CPSS-14)、贝克焦虑量表(BAI)、贝克忧郁量表(BDI)评分。术后20h取伤口引流液,测量其引流液中白细胞介素-1(IL-1)、白细胞介素-6( IL-6)及基质金属蛋白酶-9(MMP-9)含量,术后7d、14d与21d采用高频超声测量伤口中段基底部伤口宽度(WBW),术后7~14d基底部伤口宽度的变化率用来评估伤口愈合速率(HEAL)。结果:以总样本HEAL的均值为分界线,将病人分为快速愈合组(FH)和较慢愈合组(SH)。FH组17例,SH组21例(其中术后14d伤口不愈合2例,包括感染1例);两组之间在CPSS-14、BAI、BDI均存在统计学差异(P<0.05)。BAI(β=0.601,P=0.039)与HEAL呈正相关;BAI(β=-0.735,P=0.006)与IL-1呈负相关;BAI(β=-1.107,P<0.001)与MMP-9呈负相关。结论:截肢术后病人伤口愈合与患者心理状态密切相关,围手术期对截肢患者进行心理评估及心理干预对伤口愈合意义重大。

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更新日期/Last Update: 2019-06-20