术前虚拟现实磁共振成像对关节镜膝关节手术患者术前焦虑的影响：一项随机对照研究。

Effects of Preoperative Virtual Reality Magnetic Resonance Imaging on Preoperative Anxiety in Patients Undergoing Arthroscopic Knee Surgery: A Randomized Controlled Study.

机构信息

Department of Orthopaedic Surgery, Hanyang University Guri Hospital, Guri, Gyeonggi-do, Republic of Korea.

Department of Orthopaedic Surgery, Hanyang University Hospital, Seoul, Republic of Korea.

出版信息

Arthroscopy. 2019 Aug;35(8):2394-2399. doi: 10.1016/j.arthro.2019.02.037.

DOI:10.1016/j.arthro.2019.02.037

PMID:31395176

Abstract

PURPOSE

To assess the effect of a preoperative virtual reality (VR) experience of 3-dimensional (3D) reconstructed magnetic resonance images (MRIs) on anxiety reduction in patients undergoing arthroscopic knee surgery.

METHODS

Patients in the VR group watched a 3D model of their own MRI through a VR headset describing the anatomy of the knee as well as their own lesion of interest for an arthroscopic procedure. Patients in the non-VR (NR) group received standard preoperative information about their MRI. The primary outcome for analysis was the Amsterdam Preoperative Anxiety and Information Scale score to measure level of anxiety and the need for information in patients undergoing arthroscopic knee surgery. Secondary outcomes were rated with visual analog scale (VAS) scores measuring patient pain, preparedness, satisfaction, and stress.

RESULTS

Regarding the Amsterdam Preoperative Anxiety and Information Scale score, the sum S (surgery-related anxiety) and sum C (combined anxiety component) subscales showed significantly better outcomes in the VR group (median [interquartile range] for sum S = 2.0 [2.0-4.0], median [quartile 1-quartile 3] sum C = 4.0 [4.0-8.5]) than in the NR group (median [interquartile range] for sum S = 4.9 [3.0-5.0], median [quartile 1-quartile 3] sum C = 8.0 [5.3-9.8]) (P = .014 and P = .005, respectively). Regarding VAS scores, preoperative measures showed significantly better outcomes in satisfaction among VR group patients (95 [90.0-100.0]) in comparison to NR group patients (85 [70.0-96.0]) (P = .010). For postoperative VAS measures, the VR group (satisfaction score = 95 [90.0-100.0], stress score = 15 [2.5-37.5]) showed significantly better outcomes in satisfaction and stress in comparison to the NR group (satisfaction score = 85 [70.0-97.5], stress score = 30 [30.0-50.0]).

CONCLUSIONS

Application of preoperative VR experience of 3D reconstructed knee MRIs in patients undergoing arthroscopic knee surgery reduces anxiety around surgical encounters. The VR patient group was more satisfied overall and less stressed postoperatively. However, perioperative pain and preparedness were not affected by VR exposure.

LEVEL OF EVIDENCE

Level I, randomized controlled trial.

摘要

目的

评估术前虚拟现实（VR）体验 3 维（3D）重建磁共振成像（MRI）对接受关节镜膝关节手术患者焦虑减轻的影响。

方法

VR 组患者通过 VR 头戴式设备观看自己 MRI 的 3D 模型，描述膝关节解剖结构以及他们感兴趣的关节镜手术病变。非 VR（NR）组患者接受有关 MRI 的标准术前信息。分析的主要结果是阿姆斯特丹术前焦虑和信息量表评分，以衡量接受关节镜膝关节手术患者的焦虑水平和信息需求。次要结果通过视觉模拟量表（VAS）评分来衡量患者的疼痛、准备情况、满意度和压力。

结果

在阿姆斯特丹术前焦虑和信息量表评分方面，手术相关焦虑（sum S）和综合焦虑成分（sum C）子量表的结果在 VR 组（中位数 [四分位距] sum S=2.0 [2.0-4.0]，中位数 [四分位 1-四分位 3] sum C=4.0 [4.0-8.5]）明显优于 NR 组（中位数 [四分位距] sum S=4.9 [3.0-5.0]，中位数 [四分位 1-四分位 3] sum C=8.0 [5.3-9.8]）（P=0.014 和 P=0.005）。关于 VAS 评分，术前测量显示 VR 组患者的满意度明显更高（95 [90.0-100.0]），而 NR 组患者的满意度较低（85 [70.0-96.0]）（P=0.010）。对于术后 VAS 测量，VR 组（满意度评分=95 [90.0-100.0]，压力评分=15 [2.5-37.5]）在满意度和压力方面的结果明显优于 NR 组（满意度评分=85 [70.0-97.5]，压力评分=30 [30.0-50.0]）。