正颌手术对患者心身症状的影响

上海口腔医学 ›› 2015, Vol. 24 ›› Issue (1): 107-110.

正颌手术对患者心身症状的影响

李星儒,陈立强,李亚莉,孙健

青岛大学附属医院口腔颌面外科,山东青岛 266003

收稿日期:2014-02-17 出版日期:2015-02-20 发布日期:2015-07-24
通讯作者: 孙健,E-mail:sunjianqy@126.com
作者简介:李星儒（1987-）,男,硕士研究生,E-mail:binyilixingru@163.com

The change of patients’ psychosomatic symptoms after orthognathic surgery

LI Xing-ru,CHEN Li-qiang,LI Ya-li,SUN-Jian

Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University. Qingdao 266003, Shandong Province, China

Received:2014-02-17 Online:2015-02-20 Published:2015-07-24

摘要/Abstract

摘要： 目的研究牙颌面畸形患者进行正颌手术前、后心理状态的变化。方法采用SCL-90问卷对36例接受正颌手术患者手术前、后的心理状态进行评估;通过问卷调查,让患者主观评价正颌手术前、后咀嚼功能、面部形态、发音及颞下颌关节功能的改变。采用SPSS13.0软件包比较手术前、后结果,并将手术前、后结果与国内常模进行比较。结果SCL-90问卷调查显示,术前患者在强迫症状、人际关系敏感、抑郁、焦虑、恐怖、精神病性6个指标的因子分明显高于国内常模值;随访术后2年SCL-90问卷的各项指标,与国内常模值比较,均无显著差异。患者自评的正颌手术后各项指标较术前均有显著改善。结论正颌术后患者心身健康较术前明显改善,心理健康水平与常人无显著差异。

关键词: 正颌手术, 心理状况, SCL-90

Abstract: PURPOSE: To assess the change of patients’ psychological status before and after orthognathic surgery. METHODS: The psychological status in 36 patients were assessed before and after orthognathic surgery using the SCL-90 questionnaire. The patients were allowed to evaluate the changes of mastication, facial aesthetics, pronunciation and function of temporomandibular joint subjectively through the questionnaire. The data were analyzed using SPSS13.0 software package. RESULTS: Six factors including obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, phobic anxiety and psychoticism were significantly higher than norm preoperatively. No obvious abnormalities were found 2 years after operation. The self-evaluated quotas by patients after operation were significantly improved compared with those preoperatively. CONCLUSIONS: The patients’ psychosomatic symptoms are significantly improved after operation. No significant difference is found compared with ordinary people concerning psychological health.

Key words: Orthognathic surgery, Psychology, SCL-90

中图分类号:

R782.2

李星儒,陈立强,李亚莉,孙健. 正颌手术对患者心身症状的影响[J]. 上海口腔医学, 2015, 24(1): 107-110.

LI Xing-ru,CHEN Li-qiang,LI Ya-li,SUN-Jian. The change of patients’ psychosomatic symptoms after orthognathic surgery[J]. Shanghai Journal of Stomatology, 2015, 24(1): 107-110.

参考文献

[1] Bock JJ, Odemar F, Fuhrmann RA. Assessment of quality of life in patients undergoing orthognathic surgery[J]. J Orofac Orthop, 2009, 70(5): 407-419.
[2] Esperão PT, de Oliveira BH, de Oliveira Almeida MA, et al. Oral health-related quality of life in orthognathic surgery patients [J]. Am J Orthod Dentofacial Orthop, 2010, 137(6): 790-795.
[3] Naini FB, Donaldson AN, McDonald F, et al. Assessing the influence of lower facial profile convexity on perceived attractiveness in the orthognathic patient, clinician, and layperson[J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2012, 114(3): 303-311.
[4] Sinko K, Jagsch R, Benes B, et al. Facial aesthetics and the assignment of personality traits before and after orthognathic surgery [J]. Int J Oral Maxillofac Surg, 2012, 41(4): 469-476.
[5] Kovalenko A, Slabkovskaya A, Drobysheva N, et al. The association between the psychological status and the severity of facial deformity in orthognathic patients [J]. Angle Orthod, 2012, 82(3): 396-402.
[6] Espeland L, Høgevold HE, Stenvik A. A 3-year patient-centred follow-up of 516 consecutively treated orthognathic surgery patients [J]. Eur J Orthod, 2008, 30(1): 24-30.
[7] Oland J, Jensen J, Elklit A, et al. Motives for surgical-orthodontic treatment and effect of treatment on psychosocial well-being and satisfaction: a prospective study of 118 patients[J]. J Oral Maxillofac Surg, 2011, 69(1): 104-113.
[8] Rustemeyer J, Eke Z, Bremerich A. Perception of improvement after orthognathic surgery: the important variables affecting patient satisfaction[J]. J Oral Maxillofac Surg, 2010, 14(3): 155-162.
[9] Proothi M, Drew SJ, Sachs SA. Motivating factors for patients undergoing orthognathic surgery evaluation [J]. J Oral Maxillofac Surg, 2010, 68(7): 1555-1559.
[10] 匡斌, 苗丹民, 张银铃, 等. 正颌手术患者人格特征分析 [J]. 临床口腔医学杂志, 2007, 23(6): 357-358.
[11] Johnston C, Hunt O, Burden D, et al. Self-perception of dentofacial attraction among patients requiring orthognathic surgery [J]. Angle Orthod, 2010, 80(2): 361-366.
[12] Vulink NC, Rosenberg A, Plooij JM, et al. Body dysmorphic disorder screening in maxillofacial outpatients presenting for orthognathic surgery [J]. Int J Oral Maxillofac Surg, 2008, 37(11): 985-991.
[13] 陈波,张震康,李淑然,等.正颌外科术后患者的心身症状变化[J]. 中国心理卫生杂志, 2003, 17(3): 150-152.
[14] 董妮, 宋锦鳞, 邓锋, 等. 正颌外科治疗前后患者容貌变化及满意度的研究 [J]. 重庆医学, 2008, 37(5): 451-455.
[15] Nicodemo D, Pereira MD, Ferreira LM. Self-esteem and depression in patients presenting angle class III malocclusion submitted for orthognathic surgery[J]. Med Oral Patol Oral Cir Bucal, 2008, 13(1): E48-51.
[16] Nicodemo D, Pereira MD, Ferreira LM. Effect of orthognathic surgery for Class Ⅲ correction on quality of life as measured by SF-36 [J]. Int J Oral Maxillofac Surg, 2008, 37(2): 131-134.
[17] Kim SJ, Kim MR, Shin SW, et al. Evaluation on the psychosocial status of orthognathic surgery patients [J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2009, 108(6): 828-832.
[18] Al-Ahmad HT, Al-Sa'di WS, Al-Omari IK, et al. Condition-specific quality of life in Jordanian patients with dentofacial deformities: a comparison of generic and disease-specific measures [J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2009, 107(1): 49-55.
[19] Pahkala RH, Kellokoski JK. Surgical-orthodontic treatment and patients’ functional and psychosocial well-being [J]. Am J Orthod Dentofacial Orthop, 2007, 132(2): 158-164.
[20] Murphy C, Kearns G, Sleeman D, et al. The clinical relevance of orthognathic surgery on quality of life [J]. Int J Oral Maxillofac Surg, 2011, 40(9): 926-930.
[21] Schmidt A, Ciesielski R, Orthuber W, et al. Survey of oral health-related quality of life among skeletal malocclusion patients following orthodontic treatment and orthognathic surgery[J]. J Orofac Orthop, 2013, 74(4): 287-294.
[22] Rustemeyer J, Gregersen J. Quality of Life in orthognathic surgery patients: post-surgical improvements in aesthetics and self-confidence [J]. J Craniomaxillofac Surg, 2012, 40(5): 400-404.
[23] Choi WS, Lee S, McGrath C, et al. Change in quality of life after combined orthodontic-surgical treatment of dentofacial deformities [J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2010, 109(1): 46-51.
[24] 卢礼, 宋锦磷, 董妮, 等. 正颌外科患者健康相关生命质量评价的初步研究[J]. 重庆医科大学学报, 2009, 34(2): 229-231.