老年白内障患者术前焦虑障碍的影响因素分析及对术后干眼症状和视觉相关生活质量的影响

摘要 目的：探讨老年白内障患者术前焦虑障碍的影响因素，并观察术前焦虑障碍对术后干眼症状和视觉相关生活质量的影响。方法：选择2020年12月~2022年5月期间江苏省人民医院眼科收治的老年白内障患者100例作为研究对象。所有患者入院第1天采用状态-特质焦虑问卷（STAI）评估焦虑状况，采用单因素和多因素Logistic回归分析老年白内障患者发生术前焦虑障碍的影响因素，并观察其对术后干眼症状和视觉相关生活质量的影响。结果：本研究100例老年白内障患者中，有46例患者出现术前焦虑障碍，占比46.00%，平均STAI评分为（59.27±3.16）分；有54例未出现术前焦虑障碍，占比54.00%，平均STAI评分为（35.39±5.28）分。根据是否出现术前焦虑障碍将患者分为焦虑障碍组（n=46）和无焦虑障碍组（n=54）。单因素分析显示，老年白内障患者术前焦虑障碍与年龄、性别、文化程度、家庭人均月收入、外科手术史、合并基础疾病种类、是否双眼白内障、付费方式、家庭关系有关（P<0.05），而与婚姻状况、居住地无关（P>0.05）。年龄为60~69岁、家庭关系差、性别为女、文化程度为小学及以下、无外科手术史、双眼白内障、合并基础疾病种类为2种及以上是老年白内障患者发生术前焦虑障碍的危险因素（P<0.05）。焦虑障碍组术后干眼症状评分高于无焦虑障碍组（P<0.05）。焦虑障碍组社会角色限制、精神健康状态、社交功能、近距离工作、总体视觉情况、远距离工作、周边视野、独立性、一般健康状态、驾驶、色彩视觉、眼痛分值及总分均低于无焦虑障碍组（P<0.05）。结论：年龄、家庭关系、性别、文化程度、外科手术史、双眼白内障、合并基础疾病种类是老年白内障患者术前焦虑障碍的影响因素。老年白内障患者存在术前焦虑障碍可增加术后发生干眼症状的风险,并降低其视觉相关生活质量。

Analysis of the Influencing Factors of Preoperative Anxiety Disorder in Senile Cataract Patients and its Influence on Dry Eye Symptoms and Visual Related Quality of Life after Surgery

ABSTRACT Objective: To explore the influencing factors of preoperative anxiety disorder in senile cataract patients, and to observe the influence of preoperative anxiety disorder on dry eye symptoms and visual related quality of life after surgery. Methods: 100 senile cataract patients who were admitted to the ophthalmology department of Jiangsu Provincial People''s Hospital from December 2020 to May 2022 were selected as the study subjects. All patients were assessed with the State Trait Anxiety Inventory (STAI) on the first day of admission. The influencing factors of preoperative anxiety disorder in senile cataract patients were analyzed with univariate and multivariate Logistic regression analysis, and their effects on postoperative dry eye symptoms and visual related quality of life were observed. Results: Among the 100 senile cataract patients in this study, 46 patients had preoperative anxiety disorder, accounting for 46.00%, and the average STAI score was(59.27±3.16) scores. There were 54 cases without preoperative anxiety disorder, accounting for 54.00%. The average STAI score was(35.39±5.28) scores. Patients were divided into anxiety disorder group (n=46) and non-anxiety disorder group (n=54) according to whether there was preoperative anxiety disorder. Univariate analysis showed that the preoperative anxiety disorder of senile cataract patients was related to age, gender, education level, per capita monthly income of family, surgical history, types of combined with basic diseases, whether binocular cataract, payment method and family relationship(P<0.05), but not related to marital status and residence(P>0.05). The risk factors of preoperative anxiety disorder in senile cataract patients were age 60~69 years, poor family relationship, gender with female, education level of primary school or below, no surgical history, binocular cataract, and two or more types of combined with basic diseases(P<0.05). The dry eye symptom score in the anxiety disorder group was higher than that in the non-anxiety disorder group(P<0.05). The social role limitation, mental health status, social function, close work, general vision, remote work, peripheral vision, independence, general health status, driving, color vision, eye pain scores and total scores of the anxiety disorder group were lower than those of the non anxiety disorder group(P<0.05). Conclusion: Age, family relationship, gender, education level, surgical history, binocular cataract, and types of combined with basic diseases are the influencing factors of preoperative anxiety disorder in senile cataract patients. In addition, the presence of preoperative anxiety disorder in elderly cataract patients will increase the risk of dry eye symptoms and reduce the visual related quality of life of patients after surgery.