The Research Of The Influence Factors Related To Fatigue After Gynecologic Abdominal Surgery

ObjectivesOne objective of this study was in an attempt to disclose the etiology and pathogenesis of Traditional Chinese Medicine (TCM) for Fatigue by reviewing the relevant Chinese literature of TCM with approaches of grounded theory and content analysis in order to lay the preliminary foundation of Fatigue or Postoperative Fatigue. To understand that if the fatigue syndromes attacte the patients after Gynecologic abdominal surgery and how long it will last.The main purpose of the study is to observe the influence factors of the Postoperative Fatigue Syndrome, to provide basic data for Rapid recovery clinical treatment plan to be plant.MethodsThe main methods in this study were summarized as below, a) ZhongHuaYiDian, the current largest electronic version of ancient literature series of TCM, and the Chinese medical and biological medicine literature database (CBM) were selected as document retrieving sources to search the contents related to Fatigue. b) according to the grounded theory and content analysis, the unit of analysis was determined, and the classification scheme as well as coding frame were established. c) the information collection form for literature reviews was developed. d) relevant information of literature was extracted, coded and analyzed. e) descriptive statistical approach was also used in data analyses.The study uses the questiongnair survey method, the tool of the questionair is BPOM,VAS. The patients after gynecologic abdominal surgery collected from April,2010 to October,2010 in Guangdong Province Chinese medicine hospitial gynecology department. The data is disposaled by SPSS17.0, used the method of Mann-Whitney U, Kruskal-Wallis H(K),T-test and Spearman corelation analysis and so on.Result1. Study on Fatigue's Literature about Etiology and Pathogenesis of Traditional Chinese Medicine with Approaches of Grounded theory and Content analysis.(1)In the ancient literature, the pathogenesis of fatigue mainly for the internal organs pathogenesis (53.3%) and the qi or blood pathogenesis (37.4%).In the internal organs pathogenesis, the spleen and stamoch pathogenesis is the most important (61.1%), the next is the kidney pathogenesis (15.4%); In the qi or blood pathogenesis, the qi pathogenesis is the most important (52.8%),the next is the qi and blood booth sickness pathogenesis (32.0%); In the concrete pathogenesis, the pathogenesis of fatigue mainly by the weak syndrome, particularly the weak of the qi or blood, and the weak of the spleen and stamoch, and the weak of the Yin and Yang, but there are also pathogens, the main pathogen is Feng.(2) In the modern literature, the pathogenesis of fatigue also mainly for the internal organs pathogenesis (77.6%) and the qi or blood pathogenesis (53.3%). In the internal organs, the spleen and stamoch pathogenesis is aslo the most important (56.6%), the next is the liver and gall pathogenesis (54.2%); In the qi or blood pathogenesis, the qi pathogenesis is the most important (61.4%), the next is the blood pathogenesis (54.4%);In the concrete pathogenesis, the pathogenesis of fatigue mainly by the weak syndrome, particularly the weak of the qi or blood, and the weak of the Yin and Yang, and the weak of the qi of the spleen, but there are also full syndrome, mainly does not extend for the qi of the liver.2. Study of the Influence factors related to fatigue after gynecologic abdominal surgery(1)The fatigue score compiled on the third, the seventh, the fourteenth day after the Gynecologic abdominal surgery is more than that compiled before the surgery, and the fatigue score compiled on the thirtyth day and the sixtyth day after the Gynecologic abdominal surgery is fewer than that compiled before the surgery. Both of the results above are statistically significant (P<0.05). This result indicate that the fatigue after gynecologic abdominal surgery last between 14 and 30 days.(2)The fatigue score compiled on the 3rd,the 7th, the 14th and the 30th day after from the people who sufferd the Gynecologic abdominal surgery is more than that compiled from the people who sufferd abdominal speculum surgery, the result has statistics significance (P<0.05).This result indicate that the operative ingury may be the influenting factor of the Postoperative Fatigue Syndrome.(3)The fatigue score compiled the surgery increase with the operation time on the 3rd, the 7th, the 14th, the 30th and the 60th day, the result has statistics significance (P<0.05).This result hint that the operationtime may be the factor that influent the level of the fatigue of the surgery.(4) There is a positive correlation between the blood lost in the surgery and the fatigue socre compiled on the 3rd, the 7th, the 14th and the 30th after the surgery (P<0.05).This result hint that the blood lost in the surgury may be the factor that influent the level of the fatigue of the surgery.(5)The fatigue scores compiled from the people who has a fever on the firt day after the surgury is more than that compiled from the people who don t have, there is statistics significance between the two groups (P<0.05).This result indicate that the fever occured after the surgury may be the influenting factor of the Postoperative Fatigue Syndrome.(6)There are impositive correlations among the postoperative blood kalii contation and the fatigue socre compiled on the 3rd, the 7th, the 14th, the 30th and the 60th day after the surgery. There are positive correlations among the postoperative the white blood cell count contation and the fatigue socre compiled on the 3rd,the 7th,the 14th, the 30th and the 60th day after the surgery. There are impositive correlations among the postoperative hemoglobin contation and the fatigue socre compiled on the 3rd, the 7th, the 14th day after the surgery. All of the results have statistics significance (P<0.05).Those results hint that the blood kalii contation, the white blood cell count contation and the hemoglobin contation after the surgury may be the factors that influent the level of the fatigue after the surgery.(7)The fatigue score cmpiled by the older people is more than that compiled by the yonger, the result has statistics significance (P<0.05).This result indicates that the age of the patient is the influent factor of the Postoperative Fatigue Syndrome. (8)The preoperative BPOMS score compiled from the same patient is more than the postoperative one, the result has statistics significance (P<0.05).There is a positive correlation between the BPOMS score and the fatigue score compiled on the 7th,14th,60th days after the surgery, there are statistics significances among them, the result has statistics significance (P<0.05).It indicates that.the perioperative mental state of the patient may be the influenting factor of the Postoperative Fatigue Syndrome.ConclutionFatigue relate to the imbalance of the qi or blood, and also relate to the imbalance of the internal organs. In the fatigue's literature of Traditional Chinese Medicine, the pathogenesis of fatigue mainly by the weak syndrome, particularly the weak of the qi or blood, and the weak of the spleen and stamoch, and the weak of the Yin and Yang. It indicates that we would cure the Fatigue effitiontly if we use the herb which can correct the weak of the qi or blood, the weak of the spleen and stamoch, and the weak of the Yin and Yang. The study on fatigue's literature about etiology and pathogenesis of Traditional Chinese Medicine with approaches of grounded theory and content analysis can lay the preliminary foundation of Fatigue or Postoperative Fatigue.This study observes that the paticents after gynecologic abdominal surgery Suffered a series of syndroms related to fatigue, and it will last for one month.We also find that the age of the patient, operationg ingury and the emontions are important factors related to the Postoperative Fatigue Syndrome. The operation time, blood losed in the surger, the postoperative fever, the postoperative blood kalii contation, the white blood cell count contation and the hemoglobin contation may be the factors that influent the level of the fatigue after the surgery.So we would cure the POFS effitiontly if we diminish the surgery injury, decurtate the operative time, decrease the blood lost in the surgery,disposal the postoperative fever, low kalium high white blood cell count and low hemoglobin in time after the surgery, instrct the patients correctly in the perioperatiive time, accordingly we can diminish the postoperative recovery, and we also offer clinical evidences introducted in the perioperatiive time.