牙列缺损患者种植术前的焦虑水平对术后疼痛感受的影响

摘要

Objective To explore the effect of preoperative anxiety level on postoperative pain sensation in partially edentulous patients undergoing surgery for implant denture. Methods Eighty partially edentulous patients receiving implant denture were examined for preoperative anxiety level using State Trait Anxiety Inventory (STAI) and Modified Dental Anxiety Scale (MDAS) questionnaires before implantation surgery. The Visual Analogue Scale (VAS) and Present Pain Intensity (PPI) Questionnaire were used to assess the pain sensation in patients immediately after the operation. The correlations of preoperative state anxiety, trait anxiety, and dental anxiety with postoperative VAS score were analyzed. According to the assessment results of STAI, the patients were divided into little or no (score range 20-37) anxiety group (L group), moderate (38-44) anxiety group (M group), and high (45-80) anxiety group (H group) to analyze the effect of state anxiety and trait anxiety levels on postoperative pain sensation. Results Significantly positive correlations were found between preoperative state anxiety, trait anxiety and dental anxiety among the patients (P<0.01). Postoperative VAS score was positively correlated with trait anxiety score (P<0.01) and differed significantly between different trait anxiety groups (P<0.01). Compared with the patients in M and L groups, those in H group showed a significantly higher VAS score after the operation (P<0.05). Conclusion The preoperative trait anxiety level is associated with postoperative pain sensation in partially edentulous patients receiving implant denture, suggesting the necessity of preoperative anxiety intervention in clinical practice.%目的：探讨牙列缺损患者的种植术前焦虑水平对术后疼痛感受的影响。方法临床随机选取80例牙列缺损种植义齿修复的患者，在种植手术前完成状态-特质焦虑量表（STAI）、修正版牙科焦虑量表（MDAS）的填写，术后即刻采用视觉模拟评分（VAS）和现时疼痛强度问卷（PPI）对患者的疼痛感受进行测评，分析术前状态焦虑、特质焦虑、牙科焦虑与术后VAS评分的相关性，将状态-特质焦虑量表的测评分数分为3组。L组：为较少的或没有焦虑组（20~37）；M组：为适中的焦虑组（38~44）；H组：为较高的或极度的焦虑组（45~80），研究不同状态焦虑和特质焦虑水平对术后疼痛感受的影响。结果种植术前的状态焦虑、特质焦虑、牙科焦虑评分之间均有显著的正相关关系（P<0.01），种植术后的VAS评分与术前的特质焦虑评分之间存在显著的正相关关系（P<0.01），不同特质焦虑水平分组之间的VAS评分差异具有统计学意义（P<0.01），H组的VAS评分，高于M组和L组（P<0.05）。结论牙列缺损患者种植术前的特质焦虑水平与术后的疼痛感受具有一定的相关性，临床上应对术前的焦虑状况加以重视。