围手术期心理支持治疗对宫颈癌患者术后情绪及性生活质量的影响

Influence of perioperative supportive psychotherapy on the postoperative mental state and sexual life in patients with uterine cervix cancer

目的:通过问卷调查分析围手术期心理支持治疗对宫颈癌患者术后情绪及性生活质量的影响。方法:选择2000-01/2004-08中国医科大学附属第一医院妇产科宫颈癌患者82例,病理切片证实为宫颈癌。随机将患者分为2组,心理干预组42例和对照组40例。心理干预组患者术前和术后在病房实施支持性心理治疗,包括术前7d至术后7d进行自我松弛训练与自我催眠疗法,60min/次。对照组宫颈癌患者40例未进行心理支持治疗。术后1d,1,3,6,12,24个月采用抑郁自评量表和焦虑自评量表评估患者心理状况,同时调查患者的性生活满意率。结果:按意向处理分析,进入结果分析宫颈癌患者82例,心理干预组42例,对照组40例。心理干预组患者术后1d,1,3,6,12,24个月抑郁自评量表和焦虑自评量表总分逐渐降低,各时间点评分明显低于对照组(t=2.689～5.127,P<0.05～0.01)。心理干预组患者术后3,6,12,24,12个月性生活满意率逐渐增加,各时间点性生活满意率均明显高于对照组(39.4%,44.3%,49.7%,56.6%;15.6%,19.4%,21.5%,26.5%,χ2=4.819～7.871,P<0.01)。结论:围手术期心理干预可显著降低宫颈癌患者术后的心理抑郁和焦虑症状,提高患者性生活质量。

AIM:To analyze the effect of perioperative supportive psychotherapy on the pos toperative mental state and sexual life by means of questionnaire investigation in patients with uterine cervix cancer. METHODS: Eighty two patients with uterine cervix cancer diagnosed with pathol ogical section, who were selected from the Department of Obstetrics and Gynecolo gy, the First Affiliated Hospital of China Medical University between January 20 00 and August 2004, were randomly divided into psychological intervention group (n=42) and control group (n=40). Patients in the psychological intervention grou p received preoperative and postoperative supportive psychotherapy in the sickro om, including self relaxing training and self hypnothrapy 7 days preoperation and 7 days postoperation respectively, 60 minutes for each time.The 40 patients in the control group were not given supportive psychotherapy.The mental status o f the patients were evaluated with self rating depression scale and self ratin g anxiety scale at 1 day, 1, 3, 6, 12 and 24 months postoperation respectively;M eanwhile, the satisfactory rate of sexual life in the patients was investigated. RESULTS: According to intention to treat analysis, all the 82 patients with uterine cervix cancer (42 cases in the psychological intervention group and 40 c ases in the control group) were involved in the analysis of results. In the psyc hological intervention group, the total scores of self rating depression scale and self rating anxiety scale at 1 day, 1, 3, 6, 12 and 24 months postoperation were gradually decreased, and the scores at each time point were obviously lowe r than those in the control group (t=2.689 to 5.127, P< 0.05 to 0.01).The satisf actory rate of sexual life at 3, 6, 12 and 24 months postoperation was gradually raised in the psychological intervention group, and that at each time point was markedly higher than those in the control group (39.4%, 44.3%, 49.7%, 56.6% ; 15.6%, 19.4%, 21.5%, 26.5%,χ2=4.819 to 7.871,P< 0.01). CONCLUSION:Perioperative psychological intervention can significantly decrease the symptoms of postoperative depression and anxiety in patients with uterine c ervix cancer, and improve the quality of their sexual life.