Matsubara Noriaki, Miyachi Shigeru, Hososhima Osamu, Izumi Takashi, Ohshima Tomotaka, Tsurumi Arihito, Kinkori Takeshi, Yoshida Jun
Department of Neurosurgery, Nagoya University School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya-shi, Aichi 466-8550, Japan.
No Shinkei Geka. 2008 Jun;36(6):513-20.
Neuroendovascular treatment (NET) is an effective and minimally invasive procedure used for patients with vascular disease of the central nervous system. The purpose of this study was to examine anxiety levels using standardized psychometric tools and an original questionnaire among patients before and after NET.
A total of 40 patients who underwent NET were included. There were 18 patients with unruptured cerebral aneurysm, 18 with carotid stenosis, and 4 other cases. Patients were asked to complete a State-Trait Anxiety Inventory (STAI) and also to fill out a questionnaire about perioperative anxiety. It elicited the following information: (a) state-anxiety score and level before and after NET; (b) trait-anxiety score and level before and after NET; and (c) perioperative anxiety about NET. In all cases, the procedure was performed under local anesthesia.
The preprocedural state-anxiety score was high in many patients (82%). The principal cause of the preprocedural anxiety was the procedure-related complications (92%). Patients with cerebral aneurysm experienced anxiety during the procedure because they could not know which stage of the procedure was involved. Their state-anxiety score was improved in the postprocedural examination (88%). However, patients were still anxious about postoperative complications and recurrence, particularly those with cerebral aneurysm. Patients with cerebral aneurysm generally tended to experience a higher level of anxiety than those with carotid stenosis.
Though NET is apt to be thought as a relatively easy procedure, patients actually felt much anxiety, especially those with cerebral aneurysm. Due care for perioperative anxiety in patients who undergo NET is important.
神经血管内治疗（NET）是用于中枢神经系统血管疾病患者的一种有效且微创的手术。本研究的目的是使用标准化心理测量工具和一份原创问卷来检测NET患者术前和术后的焦虑水平。
共纳入40例接受NET的患者。其中有18例未破裂脑动脉瘤患者，18例颈动脉狭窄患者，以及4例其他病例。要求患者完成一份状态-特质焦虑量表（STAI），并填写一份关于围手术期焦虑的问卷。该问卷获取了以下信息：（a）NET术前和术后的状态焦虑评分及水平；（b）NET术前和术后的特质焦虑评分及水平；（c）对NET的围手术期焦虑。所有病例均在局部麻醉下进行手术。
许多患者术前状态焦虑评分较高（82%）。术前焦虑的主要原因是与手术相关的并发症（92%）。脑动脉瘤患者在手术过程中会感到焦虑，因为他们不知道手术处于哪个阶段。术后检查时他们的状态焦虑评分有所改善（88%）。然而，患者仍对术后并发症和复发感到焦虑，尤其是脑动脉瘤患者。脑动脉瘤患者通常比颈动脉狭窄患者更容易出现较高水平的焦虑。
尽管NET往往被认为是一种相对简单的手术，但患者实际上感到非常焦虑，尤其是脑动脉瘤患者。对接受NET的患者围手术期焦虑给予充分关注很重要。
