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首页> 外文期刊>Psychosomatic Medicine: Journal of the American Psychosomatic Society >Psychological stress impairs early wound repair following surgery.
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Psychological stress impairs early wound repair following surgery.

机译：心理压力会损害手术后的早期伤口修复。

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OBJECTIVE: Laboratory studies have demonstrated that psychological stress is associated with slower healing of small superficial wounds. The application of this finding to the clinical environment has not yet been undertaken. In order to do this, we investigated the relationship between psychological stress and wound repair in patients following routine surgery. METHODS: Forty-seven adults with an inguinal hernia were given a standardized questionnaire assessing psychological stress and worry about the operation before undergoing open incision repair. Wound fluid was collected from 36 participants over the first 20-hour postoperative period. Wound healing was assessed by levels of interleukin-1, interleukin-6, and matrix metalloproteinase-9 in the fluid. Other outcome measures included patient self-reports of recovery, as well as cytokine response to lipopolysaccharide stimulation of peripheral blood. RESULTS: Greater preoperative perceived stress significantly predicted lower levels of interleukin-1 in the wound fluid (beta = -0.44, p = 0.03). Greater worry about the operation predicted lower levels of matrix metalloproteinase-9 in the wound fluid (beta = -0.38, p = 0.03) as well as a more painful (beta = 0.51, p = 0.002), poorer (beta = -0.36, p = 0.04), and slower recovery (beta = 0.43, p = 0.01). CONCLUSIONS: Psychological stress impairs the inflammatory response and matrix degradation processes in the wound immediately following surgery. This finding generalizes previous laboratory research to surgical patients and expands the known influence of stress to connective tissue matrix remodelling processes. These results suggest that in clinical practice, interventions to reduce the patient's psychological stress level may improve wound repair and recovery following surgery.
机译：目的：实验室研究表明，心理压力与较小的浅表伤口愈合较慢有关。该发现尚未应用于临床环境。为此，我们调查了常规手术患者心理压力与伤口修复之间的关系。方法：对47名腹股沟疝的成人进行标准化的问卷调查，以评估在进行开放切口修复之前的心理压力和对手术的担忧。在术后的最初20小时内，从36名参与者那里收集了伤口液体。通过液体中白介素-1，白介素-6和基质金属蛋白酶-9的水平评估伤口愈合。其他结果指标包括患者自我恢复报告，以及细胞因子对外周血脂多糖刺激的反应。结果：更大的术前感知压力显着预测伤口液中白介素-1水平较低（β= -0.44，p = 0.03）。对该手术的担忧更大，预计伤口液中基质金属蛋白酶9的水平较低（β= -0.38，p = 0.03），而疼痛更严重（β= 0.51，p = 0.002），较差（β= -0.36， p = 0.04）和恢复较慢（β= 0.43，p = 0.01）。结论：心理压力会在手术后立即损害伤口的炎症反应和基质降解过程。这一发现将先前的实验室研究推广到了外科手术患者，并扩大了应力对结缔组织基质重塑过程的影响。这些结果表明，在临床实践中，降低患者心理压力的干预措施可能会改善手术后的伤口修复和恢复。

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