Issledovaniâ i Praktika v Medicine (Sep 2018)
Psychoemotional stress in somatically burdened oncological surgery patients as one of the factors of postoperative complications
Abstract
Planned surgical interven ons account for more than half of all opera ons in the Russian Federa on, of which more than 20–30% are performed for oncological diseases. Characteris c is an increase in the number of operated pa ents in older age groups with severe concomitant pathology and a high percentage of postopera ve complica ons, including due to psychoemo onal pathology, which can be excluded or adjusted at the preopera ve stage.Purpose. Evalua on of the infl uence of the psychoemo onal state of the oncochirical soma cally burdened patient on the lethality and revealing the possibility of correc on of the psychoemo onal state at the preopera ve stage.Paents and methods. In the period from 2006 to 2016 in the departments of therapy and oncology of the Regional Clinical Hospital of the City Clinical Hospital No. 40 of the Moscow City Health Department, AI.Burnazyan The FMBA of Russia analyzed the treatment of 958 soma cally burdened pa ents with various oncopathology who underwent opera ve interven on in a planned manner. An analysis of the psychoemo onal state of pa ents before and aft er surgery was performed using Hamilton diagnos c scales.Results. After a retrospec ve evalua on, it was determined that prac cally all patients of the oncosurgical profi le undergo various psychoemo onal strains of varying strength and dura on, both before and after surgery. This can disrupt the blood fl ow in the organs andssues, and lead to various complica ons, which manifests itself in the form of hypoxia and ischemia, which, in turn, jus fy the development of postopera ve delirium and myocardial infarc on.Conclusions. Clear distinctions between the anxiety severity in groups on outcomes of hospitaliza on of the oncosurgical patient were determined, and the tendency of the rela onship between the level of the anxiety state and the postopera ve complica ons that had been ridden in the early postopera ve period in soma cally burdened pa ents was determined. Patients of the oncosurgical profi le without fail are shown psychopharmacotherapy in the pre- and postopera ve periods, depending on the revealed pathology.
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