Trevisani Lucio, Sartori Sergio, Putinati Stefano, Gaudenzi Piergiorgio, Chiamenti Carlo Maria, Gilli Giuseppe, Grassi Luigi, Abbasciano Vincenzo
I Divisione di Medicina Generale, Dipartimento di Medicina, Azienda Ospedaliera Universitaria Arcispedale S. Anna, Ferrara.
Recenti Prog Med. 2002 Apr;93(4):240-4.
Patients with increased pre-endoscopic anxiety take advantage of the use of conscious sedation. However, the habit of using premedication varies according to the type of endoscopic examination. Aims of this study were: to evaluate whether different endoscopic procedures may have different effects on patient anxiety; and whether anxiety affects patient tolerance. 163 consecutive outpatients undergoing endoscopy (75 gastroscopy, 51 colonoscopy and 37 bronchoscopy) were interviewed to evaluate pre-endoscopy anxiety, by using the Spielberger State-Trait Anxiety Inventory. After endoscopy, endoscopists rated patient cooperation on a 10-cm visual analogue scale. Females had state and trait anxiety levels higher than males (50.49 +/- 1.37 vs 45.07 +/- 1.20, p < 0.01; and 44.46 +/- 1.06 vs 38.48 +/- 1.01, p < 0.01). Anxiety levels were not related with the type of endoscopic procedure. A direct relationship was observed between state and trait anxiety (p < 0.001). Patient cooperation to endoscopy was inversely related with both trait (p < 0.05) and state anxiety (p < 0.01). In conclusion, gastroscopy, colonoscopy and bronchoscopy seem to induce similar pre-endoscopy anxiety levels. Therefore, the different frequency in the use of intravenous sedation between bronchial and gastrointestinal endoscopy does not seem justified.
内镜检查前焦虑情绪加重的患者可受益于清醒镇静的使用。然而，术前用药的习惯因内镜检查类型而异。本研究的目的是：评估不同的内镜检查程序是否对患者焦虑有不同影响；以及焦虑是否影响患者耐受性。连续纳入163例接受内镜检查的门诊患者（75例胃镜检查、51例结肠镜检查和37例支气管镜检查），使用斯皮尔伯格状态-特质焦虑量表对其内镜检查前焦虑情况进行评估。内镜检查后，内镜医师采用10厘米视觉模拟量表对患者的配合程度进行评分。女性的状态焦虑和特质焦虑水平高于男性（50.49±1.37对45.07±1.20，p<0.01；44.46±1.06对38.48±1.01，p<0.01）。焦虑水平与内镜检查程序类型无关。状态焦虑和特质焦虑之间存在直接关系（p<0.001）。患者对内镜检查的配合程度与特质焦虑（p<0.05）和状态焦虑（p<0.01）均呈负相关。总之，胃镜检查、结肠镜检查和支气管镜检查似乎会引起相似的内镜检查前焦虑水平。因此，支气管镜检查和胃肠道内镜检查在静脉镇静使用频率上的差异似乎没有依据。
