高级检索

经皮耳迷走神经刺激对腹腔镜子宫肌瘤切除术患者术前焦虑及睡眠障碍的影响

Effect of transcutaneous auricular vagus nerve stimulation on preoperative anxiety and sleep disorders in patients undergoing laparoscopic myomectomy

    摘要
  • 摘要:
    目的 探讨经皮耳迷走神经刺激(taVNS)对腹腔镜子宫肌瘤切除术患者术前焦虑和睡眠质量的影响。
    方法 将106例择期行腹腔镜子宫肌瘤切除术的患者随机分为主动刺激组(a-taVNS组, n=53)和假性刺激组(s-taVNS组, n=53)。干预前(T0)、干预30 min后(T1) 和次日清晨(T2), 评估特质焦虑量表(TAI) 评分、状态焦虑量表(SAI) 评分、医院焦虑抑郁量表-焦虑(HADS-A) 评分、阿姆斯特丹术前焦虑量表(APAISa) 评分、雅典失眠量表(AIS) 评分、血流动力学参数和不良反应。计算焦虑改善程度(ΔSAI=SAIT0-SAIT1; ΔHADS-A=HADS-AT0-HADS-AT1; ΔAPAISa=APAISaT0-APAISaT1)和睡眠改善程度(ΔAIS=AIST0-AIST2), 并评估二者的相关性。
    结果 T0时点, 2组SAI、HADS-A和APAISa评分差异无统计学意义(P=0.376、0.682、0.144)。T1时点, 2组SAI、HADS-A评分差异有统计学意义(校正P < 0.05), APAISa评分差异无统计学意义(P=0.141)。与s-taVNS组相比, a-taVNS组ΔSAI、ΔHADS-A和ΔAPAISa改善值更高, 差异有统计学意义(P < 0.001)。与T0相比, a-taVNS组T2时点AIS评分降低，睡眠障碍发生率下降，差异有统计学意义(P < 0.05)。与s-taVNS组相比, a-taVNS组T2时点AIS评分和睡眠障碍患者占比降低，差异有统计学意义(P < 0.05)。a-taVNS组焦虑改善程度与睡眠改善程度呈正相关(P < 0.05), 而s-taVNS组二者无显著相关性(P>0.05)。与T0时点相比, 2组T1时点收缩压、舒张压及心率均降低，但组间各参数差异无统计学意义(P>0.05)。研究期间, 2组均未发生耳鸣、头晕、头痛、恶心、呕吐或面部潮红等不良事件。
    结论 taVNS可改善腹腔镜子宫肌瘤切除术患者术前焦虑状态，同时降低睡眠障碍发生率。

     

    Abstract:
    Objective To investigate the effects of transcutaneous auricular vagus nerve stimulation (taVNS) on preoperative anxiety and sleep quality in patients undergoing laparoscopic myomectomy.
    Methods A total of 106 patients scheduled for elective laparoscopic myomectomy were randomly divided into active stimulation group (a-taVNS group, n=53) and sham stimulation group (s-taVNS group, n=53). Trait Anxiety Inventory (TAI) scores, State Anxiety Inventory (SAI) scores, Hospital Anxiety and Depression Scale-anxiety (HADS-A) scores, Amsterdam Preoperative Anxiety and Information Scale-anxiety (APAISa) scores, Athens Insomnia Scale (AIS) scores, hemodynamic parameters, and adverse reactions were evaluated before intervention (T0), 30 min after intervention (T1), and the next morning (T2). The degrees of anxiety improvement (ΔSAI=SAIT0-SAIT1; ΔHADS-A=HADS-AT0-HADS-AT1; ΔAPAISa=APAISaT0-APAISaT1) and sleep improvement (ΔAIS=AIST0-AIST2) were calculated, and their correlations were assessed.
    Results At T0, there were no significant differences in SAI, HADS-A, and APAISa scores between the two groups (P=0.376, 0.682, 0.144). At T1, there were significant differences in SAI and HADS-A scores between the two groups (adjusted P < 0.05), while there was no significant difference in APAISa scores (P=0.141). Compared with the s-taVNS group, the a-taVNS group had higher improvement values of ΔSAI, ΔHADS-A, and ΔAPAISa (P < 0.001). Compared with T0, the AIS score decreased and the incidence of sleep disorders decreased at T2 in the a-taVNS group(P < 0.05). Compared with the s-taVNS group, the AIS score and the proportion of patients with sleep disorders decreased at T2 in the a-taVNS group (P < 0.05). There was a positive correlation between the degree of anxiety improvement and the degree of sleep improvement in the a-taVNS group (P < 0.05), while there was no significant correlation in the s-taVNS group (P>0.05). Compared with T0, systolic blood pressure, diastolic blood pressure, and heart rate decreased at T1 in both groups, but there were no significant differences in these parameters between the two groups (P>0.05). During the study period, no adverse events such as tinnitus, dizziness, headache, nausea, vomiting, or facial flushing occurred in either group.
    Conclusion The method taVNS can improve preoperative anxiety and reduce the incidence of sleep disorders in patients undergoing laparoscopic myomectomy.

     

    • HTML全文
    • 参考文献(33)
    • 相关文章
    • 施引文献
  • 资源附件(0)

/

返回文章
返回