Scavée V, Pirlet I, Terryn E, Nardella E, Michel I, Haxhe J P
Department of Thoracic and Vascular Surgery, Clinique Saint-Pierre, Ottignies.
Acta Chir Belg. 2007 Mar-Apr;107(2):166-72.
It is mandatory to perform venous surgery in ambulatory surgery units. The aim of this study is to analyse the patient's perception concerning the period before hospital discharge.
This was a prospective observational study of 100 patients who underwent primary varicose vein surgery. Venous disease was assessed according to the CEAP classification and VCSS system. The perception of anxiety or psychological apprehension was documented by simple questions. Additionally, we recorded the daily postoperative pain, the return to normal activity and the patient's satisfaction score.
Four patients required unplanned admission from the ambulatory surgery floor to the hospital unit: two for medical reasons (urinary retention and haematomas) and two ladies who stayed overnight because of a severe anxious state. When questioned about the potential anxiety before hospital discharge, the majority of patients (87%) declared no psychological apprehension. Eleven patients decided to leave the hospital despite potential distress. Patients with distress were more frequently male (p = .75) with superficial phlebitis (p = .49), pre-operative painful varicose veins (p = .13) and a higher number of surgical incisions (p = .35). The only significant difference existing between patients with or without anxiety was regarding the complication rate in the recovery room (p = .04).
Despite careful patient selection, psychological distress could not be prevented or predicted. There is no doubt however that taking these emotional factors into consideration in outpatient surgical practice is essential.
在门诊手术单元进行静脉手术是必要的。本研究的目的是分析患者对出院前这段时间的看法。
这是一项对100例行原发性静脉曲张手术患者的前瞻性观察研究。根据CEAP分类和VCSS系统评估静脉疾病。通过简单问题记录焦虑或心理忧虑的感受。此外，我们记录了术后每日疼痛、恢复正常活动情况以及患者满意度评分。
4例患者需要从门诊手术楼层非计划转入医院病房：2例因医疗原因（尿潴留和血肿），2例女士因严重焦虑状态而留院过夜。当被问及出院前的潜在焦虑时，大多数患者（87%）表示没有心理忧虑。11例患者不顾潜在痛苦决定出院。有痛苦的患者男性更为常见（p = 0.75），伴有浅静脉炎（p = 0.49）、术前疼痛性静脉曲张（p = 0.13）以及手术切口数量较多（p = 0.35）。有焦虑和无焦虑患者之间唯一显著的差异在于恢复室的并发症发生率（p = 0.04）。
尽管进行了仔细的患者选择，但心理痛苦仍无法预防或预测。然而，毫无疑问，在门诊手术实践中考虑这些情感因素至关重要。
