目的 调查小儿室间隔缺损封堵术后的焦虑状态,分析影响患儿术后焦虑的相关因素。方法 选取2016年3月-2019年2月行室间隔缺损封堵术的186例先天性心脏病患儿,在入院当天和术后1 d、术后7 d分别采用改良耶鲁围术期焦虑量表(mYPAS)对患儿的焦虑水平进行评估,调查患儿术后焦虑原因并分析患儿术后焦虑的相关影响因素。结果 与入院时相比,患儿术后1 d、7 d的mYPAS各维度评分及总分均显著高于入院时(F=10.247、9.551、8.781、11.362、7.051、6.995,P＜0.05)。学龄前期患儿入院时、术后1 d、术后7 d的mYPAS总评分均显著低于学龄期患儿(t=3.321、6.328、4.014,P＜0.05)。多因素分析显示,患儿术后1 d的焦虑影响因素包括年龄、对穿刺疼痛恐惧、对手术过程恐惧、对手术室/病房恐惧,其对患儿术后1 d焦虑的解释率为66%;术后7 d的焦虑影响因素包括年龄、对手术室/病房恐惧、出血与血肿,其对患儿术后7 d焦虑的解释率为59%。结论 患儿室间隔缺损封堵术后容易产生焦虑情绪障碍,对手术室/病房恐惧、术后出血与血肿是影响患儿术后焦虑情绪的主要因素。

Objective To investigate the anxiety status of children after ventricular septal defect occlusion,and to analyze the related factors affecting the anxiety of children after ventricular septal defect occlusion. Methods A total of 186 children with congenital heart disease who underwent ventricular septal defect occlusion were assessed by modified Yale Perioperative Anxiety Scale (mYPAS) on admission day,1 day and 7 days after operation from March 2016 to February 2019. The causes of anxiety were investigated and the related factors of anxiety were analyzed. Results Compared with that at admission,the scores of each dimension and total scores of mYPAS in 1 and 7 days after operation were significantly higher than those at admission (F=10.247,9.551,8.781,11.362,7.051,6.995,P＜0.05). The total scores of mYPAS of pre-school children at admission,1 day after operation and 7 days after operation was significantly lower than those of school-age children (t=3.321,6.328,4.014,P < 0.05). Multivariate analysis showed that the influencing factors of anxiety on the first day after operation included age,fear of puncture pain,fear of operation process and fear of operation room/ward (R²＝0.66).The influencing factors of anxiety on the seventh day after operation included age,fear of operation room/ward,hemorrhage and hematoma(R²=0.59). Conclusion s Children with ventricular septal defect occlusion are prone to anxiety disorders. Fear of operating room/ward,postoperative hemorrhage and hematoma are the main factors affecting children's anxiety after ventricular septal defect occlusion.