Registration Number
0219U000464,
0116U001203
, R & D reports
Title
To study the psychological state and quality of life in patients in the pre- and postoperative period with gynecological and extragenital surgical pathology undergoing simulaneous operations
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Head
Dronova V.L.,
Registration Date
31-01-2019
Organization
State organization "Institute of pediatrics, obstetrics and gynecology NAMS of Ukraine"
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The object of research is the psychological state and quality of life at patients undergoing simultaneous operations. Objective: to improve the results of surgical treatment and quality of life with gynecological and extragenital surgical pathology through the development of measures to ensure psychological balance. The study involved 207 patients who received surgical assistance in the Department of Operative Gynecology of the State Institution IPOG nam.acad.E.M.Lukyanova NAMS Ukraine, (the first - patients with isolated gynecological pathology (154), the second - with simultaneous pathologies (54)). Group three - with isolated surgical pathology (52), surgical department of the City Clinical Hospital No. 10, Kiev, during 2016-2018 on the basis of these departments. The peculiarities of the psychological state of patients with simultaneous, gynecological and surgical pathology, according to the methods of Spielberger - Hanin, Beck, were determined. Analysis of the level of depression showed that the majority of women who underwent surgery for isolated gynecological and surgical diseases have mild and moderate levels of depression, in patients with simultaneous pathology, in most cases, the average level of depression was found in the preoperative period. Simultaneous operative interventions detected an average level of situational anxiety, with a sharp decrease to a low level already in the first day after the operation. The presence of an average level of personal anxiety indicates a tendency to somatisation of depressive disorders, when somatic complaints come to the fore, women focus on the feeling of somatic distress, long waiting times for an operation, or, conversely, long-term reflections on consent to surgery. The definition of stress-associated hormones showed that the concentration of cortisol in patients of all three groups was significantly higher in the preoperative period. The highest concentration of the stress hormone is found in patients with simultaneous pathology. The most significant were changes in the level of prolactin on the first day after the operation of all three study groups with respect to the indicators before the operation. There was a significantly higher concentration of prolactin (28.2 ± 1.5) ng / ml, p <0.05) in patients of the 2nd group, which reflects not so much surgical (from an operating injury), but psychological stress. When performing simultaneous operations the next day after surgery, a sharp (14.8-fold) increase in the concentration of IL-6 was observed compared with the rate before the operation, which was (37.2 ± 1.3) ng / ml, p <0 , 05), however, on the following day, the concentration of the aforementioned cytokine was subject to decrease to a level that is four times the initial level (p <0.05). On the third day, there was a decrease in the level of interleukin-6 in each group, the indicators of which could be equated to the preoperative ones. Regardless of the increased volume of surgery for simultaneous pathology in relation to isolated surgical interventions in gynecological, surgical pathology, the degree of tissue trauma, or operative injury is comparable the same, which confirms the gradual decrease in the concentration of cytokine to almost reference norms. An increase in the concentration of PSA in the postoperative period was delayed for a day after the increase in the concentration of IL-6 in all study groups. The delayed response of the PSA is a consequence of the activation and stimulation of its synthesis by interleukin-6, which is confirmed by the data of scientific literature. The most informative indicator of the severity of surgical aggression is interleukin-6. It reflects proportionally the degree and dynamics of surgical trauma. The rapid decrease in the level of cytokine-6, starting from the 2nd day of the postoperative period, most objectively reflects the course of reparative processes, correlating with the terms of rehabilitation of patients in each group. At the end of the 1st month after the operation during simultaneous operations, the indicators of physical, mental health and emotional functioning tended to increase and exceeded the preoperative ones. During the following months, the trend towards an increase in these indicators continued with stabilization for 3 months of the postoperative period. On the basis of the revealed features of changes in the psychological status and degree of their manifestation, adequate therapeutic measures of psychological rehabilitation were developed, presented as an action algorithm using psychological effects (conversation, consultation) and drug correction (Befren preparation in average therapeutic doses) on the revealed violations, allowed correct psychological balance and improve the results of surgical treatment of patients with simultaneous, isolated gynecological and surgical pathology. The obtained research results are reflected in 16 scientific articles in specialized journals, 9 presentations at scientific conferences, 2 patents for a utility model, 3 certificates of registration of copyright in a work.
Product Description
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Бакунець П.П.
Бакунець Ю.П.
Дронов О.І.
Дронова В.Л.
Зємскова О.В.
Корнієнко С.М.
Мокрик О.М.
Неспрядько С.В.
Павлюк Н.П.
Рощіна Л.О.
Солорєва В.В.
Теслюк Р.С.
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2020-04-02
