结直肠癌术后患者抑郁和焦虑状况的调查研究

Investigation on Anxiety and Depression of Postoperative Patients with Colorectal Neoplasms

目的了解结直肠癌患者术后发生抑郁、焦虑状况,分析其影响因素。方法 2010年1 3月,采用Zung抑郁自评量表（SDS）、焦虑自评量表（SAS）和一般资料调查问卷,结合病历资料及心理评估,对64例结直肠癌术后患者进行测评,采用SPSS 13.0软件对数据进行统计分析。结果 64例患者SDS（47.02±10.38）分,SAS评分（42.42±7.96）分,均高于国内常模（P〈0.001）。抑郁和焦虑发生率分别为42.2%、20.3%。造口患者抑郁得分高于非造口患者（P=0.004）,Miles术患者抑郁得分高于非造瘘根治术患者（P=0.039）,姑息术患者抑郁得分高于非造瘘根治术患者（P=0.007）;家庭月收入≤1 000元者抑郁得分高于1 001~3 000元及〉3 000元者（P=0.040,0.017）。不同情况患者焦虑得分差异无统计学意义（P〉0.05）。SDS与SAS呈正相关（P〈0.001）。结论结直肠癌术后患者存在不同程度的抑郁和焦虑。护理人员尤其应关注造口术后、晚期患者及收入低下患者,并进行针对性健康教育和心理干预。

Objective To evaluate the postoperative anxiety and depression of patients with colorectal cancer and investigate its related factors.Methods From January to March 2010,64 patients who were diagnosed to have colorectal cancer and received therapeutic operations were investigated with self-rating depressive scale（SDS）,self-rating anxiety scale（SAS） and self-made related questionnaire respectively.Psychological assessment and medical records gathering were also carried out.The data collected were analyzed by SPSS 13.0.Results The total score of SDS（47.02±10.38） and SAS（42.42±7.96） of the 64 patients were both higher than those of the general population（P0.001）.The incidence rate of depression and anxiety was 42.2% and 20.3% respectively.Patients without stoma had lower SDS scores than those with stoma（P=0.004）;patients undergoing Miles operation had higher SDS scores than those receiving non-fistula formation radical operations（P=0.039）;patients receiving palliative treatment had higher SDS scores than those receiving non-fistula formation radical operations（P=0.007）;patients with family monthly income less than 1 000 RMB had higher SDS scores than those with more than 3 000 RMB and between 1 001-3 000 RMB（P=0.017,0.040）.SAS scores among different patients were not significantly different（P0.05）.SDS had positive correlation with SAS（P0.001）.Conclusions Patients with colorectal cancer have higher emotions of anxiety and depression after operation than those in the general population.It is suggested that more psychological consultation,treatment and nursing should be carried out to promote the overall physical and mental rehabilitation of the patients,especially for those having undergone stoma formation,late-stage patients and those with a low income.