Effect of preoperative anxiety and depression and sleep qualityon sequelae of Bell's palsy and its intervention strategy
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摘要:目的 探讨患者术前焦虑、抑郁及睡眠质量对贝尔面瘫后遗症手术的影响及干预对策。方法 观察患者术前1 d Sunnybrook面神经评定表、焦虑自评量表（SAS）、抑郁自评量表（SDS）以及匹兹堡睡眠质量指数量表（PSQI）评分，根据术后第6个月Sunnybrook面神经评定分值将48例接受面神经茎乳孔区松解术的患者分为预后良好组（n=40）和预后不良组（n=8）。比较2组SAS、SDS和PSQI评分。观察术前焦虑水平、抑郁程度、睡眠质量对手术疗效的影响。结果 预后良好组SAS、SDS和PSQI评分均低于预后不良组，差异有统计学意义（P < 0.05）。患者手术疗效与术前焦虑水平、抑郁程度和睡眠质量显著相关（P < 0.05）。结论 贝尔面瘫后遗症患者术前焦虑、抑郁水平和睡眠质量显著影响面神经茎乳孔区松解术的疗效，术前可对患者采取干预。Abstract:Objective To investigate the effect of preoperative anxiety, depression and sleep quality on sequelae of Bell's palsy and its intervention strategy.Methods Forty-eight patients receiving neurolysis of facial nerve of stem hole area were divided into good prognosis group (n=40) and poor prognosis group (n=8) according to Sunnybrook facial nerve evaluation score after 6 months. Preoperative 1 day Sunnybrook facial nerve evaluation form, Self-rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS) and Pittsburgh Sleep Quality Index (PSQI) scores were observed. The SAS, SDS and PSQI scores were compared between the two groups. The impacts of preoperative anxiety level, depression degree and sleep quality on the operative effect were observed.Results The SAS, SDS and PSQI scores in the good prognosis group were significantly lower than those in the poor prognosis group (P < 0.05). There were significant correlations between operative efficacy and preoperative anxiety level, degree of depression as well as sleep quality (P < 0.05).Conclusion The preoperative anxiety and depression degree as well as sleep quality of patients with sequelae of Bell's palsy significantly affect the therapeutic effect of neurolysis of facial nerve of stem hole area, and preoperative intervention can be taken for patients.
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Keywords:
- Bell's palsy /
- synkinesia /
- anxiety /
- depression /
- sleep quality /
- neurolysis
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表 1 2组一般资料比较(x±s)[n(%)]
指标 预后良好组(n=40) 预后不良组(n=8) 年龄/岁 48.3±14.1 48.5±9.4 性别 男 18(45.0) 4(50.0) 女 22(55.0) 4(50.0) 面瘫部位 左侧 18(45.0) 4(50.0) 右侧 22(55.0) 4(50.0) 文化程度 小学 6(15.0) 1(12.5) 初中 14(35.0) 2(25.0) 高中 12(30.0) 4(50.0) 大学及以上 8(20.0) 1(12.5) 
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表 2 2组SAS、SDS和PSQI评分比较(x±s)
分 指标 预后良好组(n=40) 预后不良组(n=8) SAS评分 50.1±8.3* 68.6±6.7 SDS评分 48.3±7.9* 66.0±5.8 PSQI评分 6.7±2.1* 17.0±2.1 SAS: 焦虑自评量表; SDS: 抑郁自评量表;
PSQI: 匹兹堡睡眠质量指数量表。
与预后不良组比较, *P < 0.05。
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表 3 2组SAS、SDS和PSQI评分与术后疗效相关性分析
项目 未调整 模型Ⅰ 模型Ⅱ OR(95%CI) P OR(95%CI) P OR(95%CI) P SAS评分 0.8(0.7~0.9) < 0.01 0.7(0.5~0.9) < 0.01 0.7(0.5~0.9) 0.02 SDS评分 0.7(0.6~0.9) < 0.01 0.7(0.6~0.9) < 0.01 0.7(0.6~0.9) 0.03 PSQI评分 0.3(0.1~0.8) < 0.01 0.3(0.1~0.8) < 0.01 0.3(0.1~0.8) 0.02 模型Ⅰ: 调整年龄和性别; 模型Ⅱ: 调整年龄、性别、面瘫部位和文化程度。
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