关于手术患者心理的一些问题

D. Voicu, Constantin Popazu, D. Stan, Ş. Burlea
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摘要

需要看病时总会产生一种不愉快的感觉,如果医生是外科医生,这种感觉就会更加强烈。外科医生仅次于牙医、妇科医生和精神病医生,是病人最害怕求助的医生。手术指征和治疗观点的讨论可能会引发心理情绪失衡,从而导致 "汤姆恐惧症"。事实上,这是一种复杂的心理反应,包括惧痛症(对疼痛的恐惧)、畸形恐惧症(对术后身体后遗症的恐惧)、催眠恐惧症(对麻醉睡眠的恐惧,无法从睡眠中醒来)、恐胰症(对注射、针头、手术刀的恐惧)、泛恐症(对周围发生的一切的恐惧,这里指的是医院环境),尤其是恐死症(对死亡的恐惧)。因此,可以说手术干预是对心理情感能力的一种考验。本文介绍了作者在 20 年内(2002-2021 年)对 958 名接受中型或大型手术干预(75% 在急诊模式下进行)的外科患者进行心理管理的经验。心理压力会对手术患者的反应能力和术后演变产生影响。由于时间紧迫,又没有心理医生就医疗目标提供具体建议,围手术期焦虑症的处理就由外科医生和护理人员负责。
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Some Aspects Regarding the Psychology of the Surgical Patient
The need for a medical consultation always generates an unpleasant sensation, which becomes  more accentuated, when the doctor is a surgeon. The surgeon is next to the dentist, gynecologist and psychiatrist, the doctor to whom the patient turns with the greatest fear. The operative indication and the discussion of therapeutic perspectives can trigger a psycho-emotional imbalance, leading to tomophobia. In fact, it is a complex psychological reaction, including odynophobia (fear of pain), dysmorphophobia (fear of postoperative bodily sequelae), hypnophobia (fear of anesthetic sleep, from which one could not wake up), trypanophobia (fear of injections, needles, scalpel), pantophobia (fear of everything that happens around, in this case, in the hospital environment) and above all, thanatophobia (fear of death). Therefore, it can be stated that the surgical intervention is a test of the psycho-affective capacity. The paper presents the authors' experience in 20 years (2002-2021), related to the psychological management of surgical patients, subjected to medium or large-scale surgical interventions (75% performed in emergency mode), in 958 patients. Mental stress can have consequences, both on the reactivity of the surgical patient and on his postoperative evolution. In the time crunch and in the absence of a psychologist, available to offer specific advice on medical objectives, the management of perioperative anxiety rests with the surgeon and the nursing staff.
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