Clinical Psychology And Psychoimmunology Study On Mental Stress Of Perioperative Patients

People are facing more and more nervous irritation with the developing and advancing of society. Reaction of mental and body will happen for living in the environment of the nervous irritation, this will do harm to the people's health, so the conception of health in morden society is that mental, society and body is all healthy, its model is that of biology-psychology-sociology. The new model connect pasychology and immunology, this create pychoimmunology. According to psychoimmunology, immune system and neure system affect to each other, this relationship is constructed by irritation of social and mental factor. Operation is a very strong event of life to every patient, it make patients give rise to serious mental stress. The stress sppeared anxiety before operation and depression after operation, it can affect immune function and metabolization and do harm to patients' health, so we made clinical psychology and psychoimmunology study to the patients received operation to discover the influence to the patients' health in order that we can adopt measure to intervene to get better effect.103 patients presenting for surgery were measured by Hamilton Anxiety scale(HAMA) at the day before operation and the fifthday after operation and compared before and after operation. In these patients, there were 52 workers, 16 peasants, 23 staffs and 12 teachers. Male is 39 and female is 64, their ageis 32~63, all of them is married. They didn't have mental disorder, didn't have family history of psychosis and history of operation. 59 patients received laparoscopic cholecystectomy(Lc) and 44 patients received open cholecystectomy and biliary duct exploration. The six events at the begnning of HAMA is studied and the results is that the total anxiety score measuredbefore operation was significantly higher than after operation, patients presenting for open cholecystectomy were more anxious than those receiving Lc. According to the results of this study, the perioperative patients gave rise to mental stress because of operation. Although the operation's goal is make patients healthy, it do harm to the bodies' integrity and patients have to face the danger of complication or even death. Surgeons have to tell the patients about the condition of disease and the danger of operation, it affect patients' mind seriously and the consequence lead to anxiety. Psychological intervention has to be developed to cope with the anxiety in perioperative patients.To do it well,doctors have to do something to be trusted by patients so that good relation is constructed between doctors and patients. It is difficult not to irritate patients when surgeon tell the patients about the danger of operation. The patients received Lc is less anxious because Lc do less trauma and Surgeon is skilled to do this kind of operation. In addition, the information that most of patents had recedined Lc restore to health made the patients who waited for Lc felt good, So the patients presenting for Lc were less anxious.Dynamic monitor on immune function of 33 patients received . open cholecystectomy was made. The blood of vein was taken at the first day in hospital and the day when the patients received operation to monitor the antibody and complement. The evidence showed that IgG, IgA and IgM in the patients' serum at the operating day was on lower level compared to the first day in lospital. According to psychoimmunology, negtive life events bring burden to people's mind, it give rise to mental stress. The stress can affect people's immune function, so the ability to resist pathogen(bacterium, Virus ectal) is lower. This break the balance of the organism and do harm to the people's health. Operation is a very strong event of life, it bring patients mental stress and have patients give rise to anxiety. This can affect immune function of patients and th rate of complication is higher. IgG is major antibody to resist infection, the lower level of IgG in serum result in lower ability to resist infection. Respiratory tract secete less IgA because of less IgA in serum, this lead to danger of infection. In these antibodies IgM reduced most significantly, it showed that IgM was affected by mental stress most seriously. The...