抑郁症对胸科手术患者术后住院时间及疼痛的影响

The Effects of Depression on Postoperative Pain and the Length of Hospitalization in Patients Undergoing Thoracic Surgery

目的本研究以汉密尔顿抑郁量表(HAMD)评价胸外科手术患者术前及术后的抑郁状态,并探讨术前抑郁对患者术后疼痛及住院时间的影响。方法回顾性分析2010年9月至2011年9月期间在我院胸心外科接受胸科手术198例患者入院时及出院时的HAMD量表评分,术后前3dVAS评分及住院时间等病例资料。结果与无抑郁症患者相比,抑郁症患者(HAMD评分>20)胸外科手术后的住院时间更长,术后前3d的VAS评分更高(分别为P<0.01,P<0.05);且胸外科手术患者术后住院时间及术后前3dVAS评分与入院HAMD评分具有明显相关性(分别为r=0.54,P<0.001;r=0.319,P<0.05;r=0.316,P<0.05;r=0.312,P<0.05)。结论抑郁症增加胸外科手术患者术后住院时间及术后疼痛程度,早期干预或治疗抑郁症可以改善患者的预后。

Objective The aim of this study is to assess mental status of patients undergoing thoracic surgery at admission and at discharge, using Hamilton Depression Scale （HAMD）, and explore the effects of depression on postoperative pain and the length of hospitalization. Methods HAMD scores at admission and at discharge, VAS scores in the first 3 days after operation and demographic data including age, thoracotomy, and number of days in hospital were collected retrospectively from 198 patients undergoing thoracic surgery, from September, 2010 to September, 2011. Results The length of hospitalization and VAS scores in patients with depression （HAMD score〉40） was significantly greater than for those without depression （P〈0.01,P〈0.05, respectively）. The length of hospitalization and VAS scores significantly correlated with the HAMD score at admission （r=0.54,P〈0.001;r=0.319,P〈0.05;1-0.316,P〈0.05;r =0.312,P〈0.05; respectively）. Conclusion This study suggests that depression increases the length of hospitalization for malignancy patients undergoing thoracic surgery; early intervention or treatment for depression may be required for these patients to improve outcomes.