喉癌患者术后焦虑情绪与营养状况的相关性研究

Relation between anxiety and nutriture of postoperative patients with laryngeal carcinoma

目的 探讨喉癌患者术后焦虑情绪与营养状况的关系.方法 采用焦虑自评量表（SAS）在术后24 ～48 h内对150例喉切除术患者进行焦虑的调查分析,筛选出参与研究的焦虑患者78例,根据焦虑程度分为轻度、中度、重度3个组.分别对3组患者于术前1d、术后10 d应用营养风险筛查2002（NRS2002）进行营养指标的测量,同时测量淋巴细胞计数及伤口拆线时间、拔除胃管时间、术后住院时间（指自手术结束至术后伤口愈合出院时间）的比较.结果 3组患者术后10 d的营养和免疫指标中身体质量指数（BMI）、血清白蛋白（ALB）、淋巴细胞计数比较差异均有统计学意义（F分别为58.540,88.062,61.581；P＜0.01）；伤口拆线时间、拔除胃管时间、住院时间比较差异有统计学意义（F分别为113.31,23.77,37.10;P＜0.01）；焦虑程度越高的患者其术后营养状况越差,手术预后越差.结论 喉癌患者术后焦虑程度与营养状况关系密切,焦虑程度越高其术后营养状况越差,伤口愈合越差,住院时间延长,降低喉癌患者术后的焦虑程度可以提高患者的营养状况,做好喉癌患者的心理干预可以提高患者的预后.

Objective To discuss the relationship between anxiety and nutriture of postoperative patients with laryngeal carcinoma.Methods SAS was used to investigate and analyze 150 patients 24-48 hours after laryngectomy of their anxiety,and 78 cases were chosen for further study and divided into the mile group,moderate group and severe group according to their anxiety degree.NRS2002 was used to evaluate their nutriture a day before and 10 days after operation,and lymphocyte count,stitches removal time,extubation time and hospitalization time after surgery were compared.Results There were statistically significant differences of BMI,ALB,lymphocyte count 10 days after surgery,stitches removal time,extubation time and hospitalization time after surgery among three groups （F =58.540,88.062,61.581,113.31,23.77,37.10,respectively; P ＜ 0.01）.Patients with higher degree of anxiety had worse nutriture and worse prognosis.Conclusions There is close relationship between anxiety and nutriture in postoperative patient with laryngeal carcinoma.Patients with higher level of anxiety had worse nutriture,worse wound healing and longer hospitalization time,alleviating their anxiety can help improve their nutriture,and psychological intervention can improve their prognosis.