手术/非手术治疗对脊柱转移性肿瘤患者长期心理状况的影响及疼痛控制效果

Effect of surgical and non-surgical treatments on long-term psychological condition and pain control in patients with metastatic spinal tumors

目的对比研究手术/非手术治疗对脊柱转移性肿瘤患者长期心理状况的影响及疼痛控制效果。方法采用Zung焦虑自评量表、Zung抑郁自评量表和数字疼痛分级法对脊柱转移性肿瘤确诊患者(手术组和非手术组)分别于确诊时及术后(确诊后)第1、3、6、9个月进行了5次焦虑、抑郁和疼痛测评,对比分析手术治疗及非手术治疗效果。结果 216例符合条件的脊柱转移性肿瘤患者入选本研究,其中接受脊柱肿瘤手术患者101例,未接受手术患者115例。两组确诊时焦虑、抑郁状态和疼痛程度的差异无统计学意义。从术后(确诊后)3个月开始到术后9个月,两组患者焦虑、抑郁状态均有所缓解,手术组患者焦虑、抑郁评分均低于非手术组,差异具有统计学意义(P=0.000)。手术组患者疼痛评分在9个月内降至(1.2±0.9)分,非手术组评分降至(6.4±2.0)分,手术组患者术后4次疼痛程度评分低于非手术组(P=0.000)。结论手术治疗缓解脊柱转移性肿瘤患者焦虑、抑郁状态及控制疼痛效果均优于非手术治疗。

Objective To compare the effects of surgical and non-surgical treatments on long-term psychological condition and pain control in patients with metastatic spinal tumors.Methods Using Zung’s Self-Rating Anxiety Scale,Zung’s Self-Rating Depression Scale,and Numerical Rating Scale,we examined patients with metastatic spinal tumors at diagnosis and 1,3,6,and 9 months after surgery（diagnosis） both surgical and non-surgical treatment groups.Results A total of 216 patients were enrolled in the present study,with 101 in the surgery group and 115 in the non-surgery group.There were no significant differences in the anxiety,depression or pain between the two groups at diagnosis.Anxiety and depression were relieved in both groups from the third month after surgery（diagnosis） to the ninth month after surgery,with the scores being significantly lower in the surgery group than those in the non-surgery group（P=0.000）.The mean score of pain decreased to（1.2±0.9） in the surgery group and to（6.4±2.0） in the non-surgery group after a period of 9 months.Patients in the surgery group had significantly lower pain scores in the last four assessments compared with the non-surgery group after surgery（diagnosis）（P=0.000）.Conclusion Surgical treatment is superior than non-surgical treatment in reducing anxiety and depression and controling pain in patients with metastatic spinal tumors.