整形美容患者行围手术期心理干预护理的临床研究

目的:通过对整形美容手术患者围手术期的综合心理干预,探讨整形美容患者的心理健康状况,评估心理干预对整形美容手术的重要作用。方法:对70例整形美容手术患者在围手术期进行心理干预,干预前后采用Zung焦虑自评量表(SAS)与抑郁自评量表(SDS)对患者心理状况进行评定。结果:手术后患者的SAS评分和SDS评分明显低于术前,整形美容的就诊者术后的焦虑与抑郁状况较术前有明显缓解。结论:在整形美容患者的手术治疗中,综合心理干预能够更好的改善患者的心理健康状况,对整形美容患者围手术期实施综合心理干预具有重要意义。     

121例整形美容受术者心理状态初步分析

目的探讨整形美容手术对受术者心理状态的影响。方法采用焦虑自评量表、抑郁自评量表、自尊量表、体像障碍自评量表及艾森克人格问卷的方法,对121例受术者进行问卷调查,并进行结果分析。结果在121例整形美容受术者中,术前焦虑、抑郁状态者分别为57%和27%。受术者术后自尊量表分值较术前上升2.631(P<0.01),体像障碍及精神质量表、神经质量表和掩饰程度分值分别下降6.131(P<0.01)、1.966(P<0.05)、3.458(P<0.01)和2.829(P<0.01)。术前受术者体像障碍与抑郁状态相关性r=0.193(P<0.05),回归方程为y=0.125x+30.278。结论受术者的自尊和体像障碍状态在整形美容手术术后有明显的改善。     

心理护理干预提高整形美容患者的满意度

分析整形美容手术患者的心理状态, 总结护理对策。2018年8月至2019年8月, 中国医学科学院整形外科医院C3病房用掷币法将整形美容手术患者80例(男30例、女50例, 年龄18～50岁)分为观察组、对照组各40例。对照组给予常规护理, 观察组在常规护理基础上给予心理护理, 记录两组患者护理满意度评分, 术前、术后1、7 d抑郁自评量表(SDS)、焦虑自评量表(SAS)评分结果。观察组患者在术后1、7 d时SDS评分、SAS评分明显低于对照组, 观察组护理满意度评分明显优于对照组, 各组数据比较差异有统计学意义(均P<0.05)。对整形美容手术患者的焦虑、烦躁等不良情绪, 给予护理干预可帮助患者消除负面情绪, 提高患者的满意度。     

整形美容手术对男性乳腺发育症患者心理影响的研究

目的：了解就诊整形美容外科的男性乳腺发育症（GYN）患者的心理状态,探讨整形美容手术对患者心理状态的影响。方法：采用焦虑自评量表（SAS）、抑郁自评量表（SDS）、自尊量表（SES）、体像障碍（BDD）自评量表及艾森克人格问卷（EPQ）,对65名GYN患者手术前后的心理状态进行问卷调查,分析调查结果。结果：在65名GYN患者中,术前焦虑、抑郁状态以及体像障碍状态的检出率分别为54%、57%和12%;手术前SAS、SDS和BDD自评量表分值分别为33.685±6.543、34.338±5.414和23.487±7.441,术后分别为26.442±4.278（P〈0.05）、27.968±7.112（P〈0.05）和16.184±8.544（P〈0.05）。患者术后SES分值较术前上升5.869±6.197（P〈0.01）。患者术前EPQ中的E、P和N量表的分值在常态范围之内,L表的分值超出常态标准;手术前后EPQ各表分值差异无显著的统计学意义。结论：抑郁和焦虑是GYN患者常见的心理异常状态。整形美容外科手术可以显著纠正GYN患者的消极体像,明显提高患者的自信心,恢复正常的心理状态。     

整形美容患者的心理状态研究

目的：研究整形美容患者的心理状态。方法：通过国际化标准的SCL-90量表对59例的整形患者进行术前术后一周的测评，并用统计学进行比较分析。结果：整形美容患者与常模比较，SCL-90总分、躯体化、抑郁、焦虑及人际关系、敏感因子高于常模，差异有显著性；患者术后与术前比较，术后SCL-90总分、躯体化、抑郁、焦虑及人际关系、敏感因子低于术前，差异有显著性。结论：对整形美容患者通过国际化标准的心理量表测量，对其心理状态分析，解除其心理障碍，同时选择合适的手术方式，解决患者的形体畸形。这种把心理分析、心理辅导运用于整形美容手术的科学方法，对今后大力开展整形美容专业，具有重要意义。     

美容整形受术者术前生活质量及其与术后满意度的相关研究

目的：探讨美容整形受术者的术前生活质量及其与术后满意度的相关性。方法：选用＂生活质量综合评定问卷（GQOLI-74）＂对美容整形受术者进行术前生活质量调查,术后2个月随访受术者术后满意度,用SPSS16.0进行统计分析。结果：生活质量调查结果为：躯体功能维度（63.93±8.44）、心理功能维度（70.61±10.60）、社会功能维度（70.27±10.89）、物质生活维度（67.82±13.88）、生活质量总评（14.06±2.53）、总评分（297.31±24.83）;术后满意度方面,有16.2%的受术者术后非常满意,64.9%比较满意,18.9%不太满意,无非常不满意。术后满意度与生活质量综合评定问卷的第F26、46、57、69、72条目存在相关关系。结论：美容整形受术者术前生活质量较高,其与术后满意度有相关性。     

颜面部整形患者术前情绪状态测评

目的:研究颜面部整形美容患者术前的情绪状态,为术前准备和术后综合治疗提供依据。方法:用焦虑自评量表(SAS)和抑郁自评量表(SDS)对33例整形美容外科受术者进行术前测验,同时用33名正常人作为对照组。结果:手术组SAS 和SDS得分分别为49.75±6.59和54.02±9.79,以SAS和SDS≥50为界值,结果显示得分明显高于对照组。结论:颜面部整形美容患者在术前存在着较明显的焦虑和抑郁情绪反应。     

鼻整形美容受术者的心理研究

目的调查鼻整形美容受术者围手术期及术后的心理特点并进行分析。方法采用一般资料问卷、情感平衡量表、Rosenberg自尊量表、鼻阻塞症状评估量表等对北京大学第三医院成形外科的153例鼻整形美容受术者进行调查。结果鼻整形美容受术者情感平衡量表和Rosenberg自尊量表总分术后3个月较术前均增高(P0.05);鼻阻塞症状评估量表总分术后3个月较术前降低(P0.05)。结论鼻整形美容受术者术前情感和自尊水平不高,整形美容手术对改善其情感和自尊水平具有一定的帮助作用,且鼻阻塞症状作为受术者的主要不适症状应得到关注。     

整形修复手术对唇裂术后继发畸形患者体像与人格状态影响的研究

目的：调查唇裂术后继发畸形患者的体像障碍特点及人格状态,探讨整形修复手术对唇裂术后继发畸形患者体像与人格状态的影响。方法：采用体像障碍自评量表及艾森克人格问卷,对75例唇裂术后继发畸形患者于整形手术前后进行问卷调查,分析结果。结果：体像障碍状态术前的检出率为13．3％（10例）。75例患者体像障碍自评量表评分手术前为（23．488±11．192）分,手术后下降为（15．846±11．219）分（P=0．000）;术后躯体缺陷感、情绪受损度和社会交往度3个方面改善明显,表现为评分较术前明显降低（P〈0．05）。患者术前艾森克人格问卷中的神经质或情绪的稳定性量表（N量表）、精神质量表（P量表）及掩饰量表（L量表）的分值分别为（49．381±11．754）分、（49．102±8．569）分和（45．781±9．826）分,术后分别为（45．833±12．802）分、（47．689±7．758）分和（47．939±11．083）分,术后与术前比较,差异均有显著性（P〈0．05或P〈0．01）。结论：唇裂术后继发畸形患者体像障碍状态的比例较高、整形修复手术可明显纠正患者的消极体像,提高患者的自信心;术后患者情绪稳定性明显提高,社会适应性显著增强,心理防御显著提高。     

美容整形就医者围手术期心理状态分析与护理

目的:了解美容整形就医者的不同心理需求和美容动机,及其术前术后的心理状况,分析心理因素对手术效果评价的影响。方法:针对就医者的不同心理状况,在术前、术中及术后给予相关干预。结果:对就医者给予相关的心理疏导和心理护理后,使其提高手术满意度。结论:对整形手术就医者及时地进行心理护理,能够有效的减轻或消除其不良心理状态,提高护理服务质量,避免医疗纠纷,从而提高就医者对手术效果的满意度,使手术效果得到最好的评价。     

Perioperative and long-term morbidity and mortality after above-knee and below-knee amputations in diabetics and nondiabetics

We performed a retrospective review of a vascular surgery quality assurance database to evaluate the perioperative and long-term morbidity and mortality of above-knee amputations (AKA, n = 234) and below-knee amputations (BKA, n = 720) and to examine the effect of diabetes mellitus (DM) (181 of AKA and 606 of BKA patients). All patients in the database who had AKA or BKA from 1990 to May 2001 were included in the study. Perioperative 30-day cardiac morbidity and mortality and 3-yr and 10-yr mortality after AKA or BKA were assessed. The effect of DM on 30-day cardiac outcome was assessed by multivariate logistic regression and the effect on long-term survival was assessed by Cox regression analysis. The perioperative cardiac event rate (cardiac death or nonfatal myocardial infarction) was at least 6.8% after AKA and at most 3.6% after BKA. Median survival was significantly less after AKA (20 mo) than BKA (52 mo) (P < 0.001). DM was not a significant predictor of perioperative 30-day mortality (odds ratio, 0.76 [0.39-1.49]; P = 0.43) or 3-yr survival (Hazard ratio, 1.03 [0.86-1.24]; P = 0.72) but predicted 10-yr mortality (Hazard ratio, 1.34 [1.04-1.73]; P = 0.026). Significant predictors of the 30-day perioperative mortality were the site of amputation (odds ratio, 4.35 [2.56-7.14]; P < 0.001) and history of renal insufficiency (odds ratio, 2.15 [1.13-4.08]; P = 0.019). AKA should be triaged as a high-risk surgery while BKA is an intermediate-risk surgery. Long-term survival after AKA or BKA is poor, regardless of the presence of DM.     

Postoperative nausea and vomiting and opioid-induced nausea and vomiting: guidelines for prevention and treatment

Postoperative nausea and vomiting (PONV) causes patient discomfort, lowers patient satisfaction, and increases care requirements. Opioid-induced nausea and vomiting (OINV) may also occur if opioids are used to treat postoperative pain. These guidelines aim to provide recommendations for the prevention and treatment of both problems. A working group was established in accordance with the charter of the Sociedad Espa?ola de Anestesiología y Reanimación. The group undertook the critical appraisal of articles relevant to the management of PONV and OINV in adults and children early and late in the perioperative period. Discussions led to recommendations, summarized as follows: 1) Risk for PONV should be assessed in all patients undergoing surgery; 2 easy-to-use scales are useful for risk assessment: the Apfel scale for adults and the Eberhart scale for children. 2) Measures to reduce baseline risk should be used for adults at moderate or high risk and all children. 3) Pharmacologic prophylaxis with 1 drug is useful for patients at low risk (Apfel or Eberhart 1) who are to receive general anesthesia; patients with higher levels of risk should receive prophylaxis with 2 or more drugs and baseline risk should be reduced (multimodal approach). 4) Dexamethasone, droperidol, and ondansetron (or other setrons) have similar levels of efficacy; drug choice should be made based on individual patient factors. 5) The drug prescribed for treating PONV should preferably be different from the one used for prophylaxis; ondansetron is the most effective drug for treating PONV. 6) Risk for PONV should be assessed before discharge after outpatient surgery or on the ward for hospitalized patients; there is no evidence that late preventive strategies are effective. 7) The drug of choice for preventing OINV is droperidol.     

Body composition assessment and methodology in nonathletic and athletic adolescent and adult males and females

The purpose of this review is to outline methodology for assessing body composition utilizing anthropometric and densitometric techniques. The objective of body composition assessment is to measure body fat and lean body mass. The quantity of these components varies due to growth, physical activity, dietary regimens, and aging. Anthropometric techniques incorporate selected skinfolds, circumferences, skeletal widths, or other variables to estimate body composition within k2.0-4.0%. These techniques are adequate for field testing of groups or individuals, but are population specific. Densitometry measures body volume irrespective of physique, sex, or age. This laboratory technique estimates body composition within 1.0-2.0%, is more difficult to administer, but is not population specific. Some limitation exists with any present technique due to biological variability and incomplete research of reference body composition in children, females, and the aged. J Orthop Sports Phys Ther 1984;5(6):336-347.