Dynamics of psycho-emotional changes after functionally sparing gynaecological operations

The objective: to estimate the dynamics of psycho-emotional changes after functionally sparing gynaecological operations. Materials and methods. As a result of clinical-and-statistical research of primary medical document of gynaecological permanent establishment of copies information from 520 medical histories of gynaecological patients, which was executed functionally-sparing operations. A structure and dynamics of gynaecological diseases was analysed, the specific weight of organpreserving operations was determined with the different types of accesses and volume of surgical treatment. From this group of gynaecological patients a basic group (224 women) and group of comparison (108 women), which parted on 2 sub-groups (after radical operations and after conservative therapy), was selected (with the observance of rules of statistical and clinical selection), comparable on age, by the stage and severity of disease. Plugging criteria in a basic group were women with specific gynaecological diseases (prolapsus of front and back wall of vagina II, III degree, from the elongation of cervix, cystocele and rectocele; by the uterine fibroids of different form and sizes (to 16–17 weeks pregnancy); of high quality formations of appendages of uterus and by the ovarian apoplexy for the women of reproductive period). In the process of complex research modern and adequate methods were used clinical-andstatistical, medical-and-social, clinical, psychological research with the estimation of efficiency by the analysis of dynamics of indexes of quality of life. Results. Cross-correlation connection is set between the type of operating access and expressed of reactive and personal anxiety (after a scale Ch.D. Spilbergera). A high reactive anxiety is marked at greater part of women after Pfannenshtiel incision and in operated by vaginal access, what for women after laparoscopic operations. A reactive and personal anxiety is expressed to the operation it was marked in 58,9 % women, through a half-year after an operation saved in 57,6 %, and in the separated period it is marked only in 24,3 % women. To the operation severe degree of syndrome (after a scale of Kupperman menopausal index) of menopause observed in most (79,5 %) women, through a half-year after an operation a severe degree was observed only in 15,4 % women, and in a remote period in 5,1 % women, that testifies to efficiency functionally sparing operations. Psycho-emotional, neurovegetative, exchange-endocrine violations are expressed at greater part of women after radical gynaecological operations (13,6 %) as compared to women after organpreserving operations (8,0 %) and for patients after conservative therapy (2,4 %) (р < 0,05). The clinically expressed alarm and depression (after a scale of M. Gamil’ton) is expressed anymore for women to the operation (11,6 %). Through a half-year and in a remote period after an operation this index reduced considerably (1,2 %) (р < ,05). It is well-proven that for women after laparoscopic operations the psycho-emotional state is more favourable (to a 64,3 ± 1,2 point), as compared to the state for women after Pfannenshtiel incision (to a 60,9 ± 2,1 point) and after vaginal operations (to a 59,7 ± 1,3 point, at р < 0,05). However after functionally sparing operations for all women irritability, fear, anxiety, is saved in an insignificant measure and other psycho-emotional displays. Conclusion. At the use of the specialized psychological scales found out conformities to law, which testify to the expressed reactive anxiety, depression, signs of climacteric syndrome (neurovegetative, metabolic and psycho-emotional changes), which are stays after an operation (to 6 months) and sharply go down in a remote period (after 2), which is instrumental in the considerable improvement of the psycho-emotional state, self-esteem of health and quality of life.