• Psychological status of female patients with gynecological, surgical and combined gynecological pathology in pre- and postoperative periods in combination with detection their hormonal homeostasis

Psychological status of female patients with gynecological, surgical and combined gynecological pathology in pre- and postoperative periods in combination with detection their hormonal homeostasis

PERINATOLOGIYA I PEDIATRIYA. 2017.2(70):58-63; doi 10.15574/PP.2017.70.58

Dronova V., Dronov A., Teslyuk R., Mokryk A.
SI "Institute of Pediatrics, Obstetrics and Gynecology of NAMS of Ukraine", Kyiv
Bogomolets National Medical University, Kyiv, Ukraine
Zemskov Centre of the Hepatic, Pancreatic and Biliary Tract Surgery, Kyiv, Ukraine

Aim — to study the peculiarities of the psychological status of female patients with gynecological, surgical and combined gynecological pathology during the pre- and postoperative periods according to Spielberger-Khanin Anxiety Scale and Beck's depression inventory together with detection their hormonal homeostasis.

Materials and methods. The research included 110 female patients, who were provided surgery at the department of operative gynecology of Institute of Pediatrics, Obstetrics and Gynecology of NAMS of Ukraine. The 1st group comprised 83 female patients with isolated gynecological pathology, the 2nd group included 27 women with simultaneous pathology, and the 3rd group consisted of 26 female patients with isolated surgical pathology, who were provided surgery at the department of surgery of the Kyiv municipal clinical hospital No. 10. The research was conducted during ten months period in 2016 in the abovementioned departments. The concentration of cortisol was detected by means of counter Gamma-12 No. 170 and prolactin was measured with the help of an immunoenzyme method using the XEMA diagnostic test systems (Russia). The optical density was measured on a MSR-1000 photometer (USA) with a wavelength of 40 nm. Peculiarities of the female patients' psychological status with simultaneous, isolated gynecological and surgical pathology were determined according to Spielberger-Khanin Anxiety Scale and Beck's depression inventory.

Results and conclusions. The mild-to-moderate depression in most women of the 1st and the 3rd groups was detected. Instead, in the majority of patients of the 2nd group the moderate-to-severe depression in the preoperative stage were diagnosed that may be explained by the leading mechanism of psychological defense in women with maladaptation.

The patients of the 2nd group had moderate level of state anxiety with a sharp decrease to a low level just in the 1st day after the surgery. The presence of a high level of trait anxiety showed a tendency to somatization of depressive disorders. According to the tests of stress-associated hormones in the examined women' serum, the significant changes of the mean values of prolactin and cortisol concentrations were observed. The highest concentration of stress hormones was detected in female patients of the 2nd group (497.5±20.5, p<0.05). The most significant changes of prolactin were diagnosed during the 1st day of postoperative stage in all patients of three research groups in comparison to the concentrations before the surgical intervention. Statistically significant prolactin concentration compared to the initial results (28.2±1.5 ng/ml, p<0.05) in the 2nd group reflects psychological stress, rather than surgical (caused by the operational trauma) one.

Key words: psychological status of patients, pre — and postoperative periods, gynaecological and surgical pathology, Spielberger-Khanin Anxiety Scale, Beck's depression inventory, endocrine homеostasis.

References
1. Baraboshin AT. (2007). Psihoemotsionalnyiy status i vozmozhnosti ego korrektsii u bolnyih obschehirurgicheskogo profilya. Diss … kand med n. Yaroslavl: 184.

2. Bek A, Rash A, Sho B, Emeri G. (2003). Kognitivnaya terapiya depressii. Sankt-Peterburg, Piter: 304. (Seriya «Zolotoy fond psihoterapii»).

3. Naumenko HM, Chaban OS. (2013). Indyvidualno-psykholohichni kharakterystyky stanu zhinok pislia perenesenykh operatyvnykh vtruchan z pryvodu leiomiomy matky. Medytsyna transportu Ukrainy. 1: 9—14.

4. Rusina NA. (2013). Reaktsii adaptatsii patsientov onkologicheskoy kliniki. Meditsinskaya psihologiya v Rossii: Elektron nauch zhurn. 5(22): http://www.mprj.ru/archiv_global/2013_5_22/nomer/nomer01.php.

5. Rusina NA, Baraboshin AT, Larichev AB. (2013). Emotsionalnyiy stress hirurgicheskih i onkologicheskih patsientov. Meditsinskaya psihologiya v Rossii. Elektron nauch zhurn. 5(22). http://mprj.ru.

6. Sviridova VV. (2009). Porivnialna kharakterystyka psykhoemotsiinoho stanu zhinok, yaki perenesly operatyvni vtruchannia na vnutrishnikh statevykh orhanakh. Medytsynskaia psykholohyia. 4; 1: 82—88.

7. Fedorov AV, Kriger AG, Kolyigin AV, Kochatkov AV. (2011). Odnomomentnyie operatsii. Terminologiya (obzor literaturyi i sobstvennoe predlozhenie). Hirurgiya. 7: 72—76.

8. Dronova VL, Teslyuk RS, Lutsenko OV, Nastashenko MI. (2014). Hirurgicheskiy stress u zhenschin s sochetannoy ginekologicheskoy i ekstragenitalnoy patologiey. Zdorove zhenschinyi. 6(92): 132—136.

9. Yuzhakov MM, Avdeeva DK, Nguen DK. (2015). Obzor metodov i sistem issledovaniya emotsionalnogo stressa cheloveka. Sovremennyie problemyi nauki i obrazovaniya (elektronnyiy nauchnyiy zhurnal). 2—2. https://www.science-education.ru/ru/article/view?id=22753.

10. Desborough JP. (2000, Jul). The stress response to trauma and surgery. British journal of anaesthesia. 85(1): 109—117. — doi 10.1093/bja/85.1.109. PMID 10927999.

11. Grainne Nicholson, George Hall (2004). Endocrine and metabolic response to surgery. BJA: CEACC — Contin Educ Anaesth Crit Care Pain. 4; Is 5: 144—147.

12. Roseske NC. (2007). Hysterectomy and other gynecological surgeries: a psychological view. Women's place in medical and psychological interfaces. 1: 172—180.

Содержание журнала Full text of article