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乳房假体植入对二重应激下乳腺癌患者心理应激、生存质量的影响 被引量:2

Effects of breast prosthesis implantation on psychological stress and quality of life in patients with breast cancer under double stress
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摘要 目的探讨乳房假体植入对二重应激下乳腺癌患者心理应激、生存质量的影响。方法选取2021年7月至2022年7月温州医科大学附属第一医院外科收治的乳腺癌患者104例为研究对象,采用随机对照研究方法,按照随机数字表法分为对照组(52例)和观察组(52例)。所有患者进行乳腺癌根治术治疗,观察组患者在乳腺癌根治术的基础上进行乳房假体植入。比较两组患者手术时间、住院时间,术前与术后3个月心理状态评分,术后3个月乳房美观恢复效果,世界卫生组织生活质量评定量表(WHOQOL-100),以及术后两组患者皮下积液、皮瓣坏死等的发生情况。结果两组患者手术时间差异无统计学意义(P>0.05),而观察组患者住院时间为(10.89±2.34)d,短于对照组的(21.06±3.82)d(t=16.37,P<0.001);术后3个月,两组患者焦虑自评量表(SAS)、汉密尔顿焦虑量表(HAMA)、抑郁自评量表(SDS)、汉密尔顿抑郁量表(HAMD)评分均比术前低,且观察组患者各项评分分别为(39.02±5.21)分、(19.02±2.51)分、(16.03±2.55)分、(41.89±3.56)分,均低于对照组的(50.76±4.85)分、(28.97±2.66)分、(53.41±4.56)分、(24.88±2.32)分(t=11.89、19.62、14.77、18.51,均P<0.001);观察组患者术后3个月乳房恢复优良率[96.15%(50/52)]高于对照组[69.23%(36/52)](Z=5.40,P<0.001);术后3个月,两组患者总体健康、躯体功能、社会功能、认知功能、角色功能及对照组情感功能评分均较术前降低,观察组情感功能评分较术前升高,观察组各项评分分别为(55.87±12.70)分、(55.89±12.34)分、(35.05±11.25)分、(55.87±7.88)分、(58.77±14.05)分,均高于对照组的(43.75±12.58)分、(47.50±12.87)分、(28.04±10.13)分、(39.87±8.06)分、(32.05±13.85)分、(74.52±14.88)分(t=4.89、3.39、3.34、10.24、9.77,P<0.001、0.001、<0.001、<0.001、<0.001、0.003)。观察组患者并发症总发生率[3.85%(2/52)]低于对照组[17.31%(9/52)](χ^(2)=4.98,P=0.026)。结论乳腺癌根治术联合乳房假体植入应用于乳腺癌患者的治疗中,可缩短患者住院时间,提高乳房恢复优良率,缓解负性情绪,改善生活质量,并减少并发症的发生。 Objective To investigate the effect of breast prosthesis implantation on psychological stress and quality of life in patients with breast cancer under double stress.Methods A total of 104 patients with breast cancer who received treatment in the Department of Surgery,The First Affiliated Hospital of Wenzhou Medical University from July 2021 to July 2022 were included in this study.These patients were randomly divided into a control group(n=52)and an observation group(n=52).All patients underwent radical mastectomy.The patients in the observation group received breast prosthesis implantation in addition to radical mastectomy.Operative time,length of hospital stay,psychological state scores before and 3 months after surgery,aesthetic recovery effect of breast 3 months after surgery,WHO Quality of Life Rating Scale(WHOQOL-100)score,postoperative occurrence of subcutaneous effusion,and flap necrosis were compared between the two groups.Results There was no significant difference in operative time between the two groups(P>0.05).The length of stay in the observation group was(10.89±2.34)days,which was significantly shorter than(21.06±3.82)days in the control group(t=16.37,P<0.001).At 3 months after surgery,the scores of the Self-rating Anxiety Scale(SAS),Hamilton Anxiety Scale(HAMA),Self-rating Depression Scale(SDS),and Hamilton Depression Scale(HAMD)in both groups were significantly lower than those before surgery.At 3 months after surgery,the scores of SAS,HAMA,SDS,and HAMD in the observation group were(39.02±5.21)points,(19.02±2.51)points,(16.03±2.55)points,and(41.89±3.56)points,which were significantly lower than(50.76±4.85)points,(28.97±2.66)points,(53.41±4.56)points,and(24.88±2.32)points in the control group(t=11.89,19.62,14.77,18.51,all P<0.001).At 3 months after surgery,the excellent and good rate of breast recovery in the observation group was[96.15%(50/52)],which was significantly higher than[69.23%(36/52)]in the control group(Z=5.40,P<0.001).At 3 months after surgery,the scores of overall health,physical function,social function,cognitive function,and role function in each group were significantly higher than those before surgery,and the sole of emotional function in the observation group was significantly higher than that in the control group.At 3 months after surgery,the scores of overall health,physical function,social function,cognitive function,and role function in the observation group were(55.87±12.70)points,(55.89±12.34)points,(35.05±11.25)points,(55.87±7.88)points,and(58.77±14.05)points,respectively,which were significantly higher than(43.75±12.58)points,(47.50±12.87)points,(28.04±10.13)points,(39.87±8.06)points,(32.05±13.85)points,(74.52±14.88)points in the control group(t=4.89,3.39,3.34,10.24,9.77,P<0.001,0.001,<0.001,<0.001,<0.001,0.003).The incidence of complications in the observation group was[3.85%(2/52)],which was significantly lower than[17.31%(9/52),χ^(2)=4.98,P=0.026]in the control group.Conclusion Radical mastectomy combined with breast prosthesis implantation for the treatment of breast cancer patients can shorten the length of hospital stay,increase the excellent and good rate of breast recovery,reduce negative emotions of patients,improve quality of life,and reduce the occurrence of complications.
作者 张一帆 王蓉蓉 胡宏叶 Yifan Zhang;Rongrong Wang;Hongye Hu(Operating Room,The First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,Zhejiang Province,China;Department of Breast Surgery,The First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,Zhejiang Province,China)
出处 《中国基层医药》 CAS 2023年第10期1489-1494,共6页 Chinese Journal of Primary Medicine and Pharmacy
基金 浙江省温州市基础性医疗卫生科技(Y20210638)。
关键词 乳房切除术 根治性 假体植入 乳腺肿瘤 心理应激 生存质量 焦虑 抑郁 Mastectomy,radical Prosthesis implantation Breast neoplasms Psychological stress Quality of life Anxiety Depression
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