不同术式喉癌患者手术前后心理状况变化分析

Psychological status before and after different laryngectomies in patients with laryngeal carcinoma

目的探讨不同术式喉癌患者术前与术后心理状况变化情况。方法采用症状自评量表(SCL-90)对41例喉癌患者在术前以及术后1、6个月的心理状态进行评估,并与国人常模进行比较。结果 SCL-90评分结果显示术前喉癌患者在总分及躯体化、焦虑、抑郁3个因子分均明显高于正常对照组;喉全切除患者术后在总分及躯体化、焦虑、抑郁、偏执4个因子分高于正常对照组和喉部分切除患者,术后1、6个月的总分及各因子分无明显改变。喉部分切除患者术后1个月时除焦虑因子分高于正常对照组,总分及其他因子分与正常对照组无明显差异,而术后6个月总分及各因子分与正常对照组无明显差异。结论喉癌患者术前存在不良心理状况,不同手术方式对喉癌患者术后心理状况存在不同影响。提示在手术治疗喉癌的同时应关注患者的心理状况并在术后根据不同术式的患者采用不同的心理干预以帮助其改善生存质量。

OBJECTIVE To explore the preoperative and postoperative psychological characteristics in laryngeal carcinoma patients with different laryngectomies. METHODS By the symptom Checklist 90 （SCL-90）, the psychological status of 41 cases of laryngeal carcinoma were evaluated at pre-operation, 1 month and 6 month after operation, and were compared with normal persons. RESULTS There were significant differences between laryngeal carcinoma patients and normal persons in the total score and three factor scores of SCL-90. These three factors were somatization, anxiety and depression. The total score and four factor scores of SCL- 90 were higher in the post-operative patients with total laryngectomy than patients with partial laryngectomy and normal person. The four factors were somatization, anxiety, depression and stubborn. There was no significant difference between post-operative 1 month and 6 month in patients with total laryngectomy in the total score and factor scores of SCL-90. Only one factor score of anxiety was higher in the patients with post partial laryngectomy at one month than normal persons. There was no significant difference between the patients of post partial laryngectomy at 6 month and normal persons in the total score and factor scores of SCL-90. CONCLUSION The psychological status of preoperative patients with laryngeal carcinoma is bad. Either total or partial laryngeetomy had a greater influence on the psychological health status of postoperative patients. We should pay attention to the psychological status for laryngeal carcinoma patients and psychological interference should be given for different laryngectomees. So we could help them improve the quality of life after operation.