肺部肿瘤患者术后焦虑及抑郁症状共病及其影响因素

Comorbidity and risk factors of depressive and anxious symptoms in postoperative patients with lung tumor

目的:比较手术治疗的肺部良性肿瘤与早期、中期肺癌患者的焦虑及抑郁症状的检出比率,探讨其影响因素。方法:研究对象为就诊于某三级综合医院的283例接受手术的肺部肿瘤患者,其中肺部良性肿瘤或病变患者107例,早期肺癌患者58例,中期肺癌患者118例。采用自编调查表收集社会人口学及临床相关信息,使用抑郁自评量表(SDS)和焦虑自评量表(SAS)分别评价肿瘤患者抑郁和焦虑症状,SDS标准分>53分记为有抑郁症状,SAS标准分>50分记为有焦虑症状。结果:肺部良性肿瘤或病变患者无明显焦虑及抑郁症状,早期和中期肺癌患者中53.40%存在焦虑症状,43.44%存在抑郁症状,差异有统计学意义(P<0.001)。多重线性回归分析显示,中期肺癌(β=29.70,P<0.001)及年龄65岁以上(β=2.58,P=0.018)是发生抑郁症状的危险因素,相对于良性肿瘤及早期肺癌患者,中期肺癌患者焦虑症状更重(β=27.22,P<0.001)。结论:中期肺癌较良性肿瘤及早期肺癌更加容易导致患者出现焦虑和抑郁等负面心理应激;且老年肿瘤患者更容易出现抑郁症状。

Objective： To compare symptoms of anxiety and depression in postoperative patients with benign pulmonary lesions,early and middle stage lung cancers,and to explore risk factors of anxiety and depression in lung tumor patients. Methods： In a tertiary comprehensive hospital,283 lung tumor patients who underwent curative surgical resection were enrolled,including 107 benign pulmonary lesions patients,58 patients in early stage,and 118 patients in middle stage of lung cancer. Self-designed general information questionnaires were used to collect sociodemographic information and some clinically relevant information,while Self-Rating Depression Scale（ SDS） and Self-Rating Anxiety Scale（ SAS） were used to evaluate symptoms of depression and anxiety. Those whose standard scores of SDS was 53 and over were defined as positive depressive symptom,and those standard whose scoresof SAS was 50 and over were defined as positive anxiety symptom. Results： The patients with benign pulmonary lesions had no obvious depressive and anxious symptoms, while among patients in early and middle stage of lung cancer,55 patients（ 33. 40%） had anxious symptoms and 43 patients（ 43. 44%） had depressive symptoms,and the difference were statistically significant（ P〈0. 001）. The multiple linear regression showed that only patients with middle-stage lung cancer（ β = 29. 70,P〈0. 001） and patients aged 65 years and over（ β = 2. 58,P = 0. 018） were positively associated with the mean score of SDS,while the mean score of SAS among the patients with middlestage lung cancer was statistically higher than that among other lung tumor patients（ β = 27. 22,P〈0. 001）. Conclusion： It indicates that compared with patients with benign pulmonary tumor or early-stage lung cancer,patients with middle-stage lung cancer might have a risk of anxious and depressive symptoms,while the elderly cancer patients have a higher risk of depressive symptom.