结直肠癌患者接受不同治疗方法的焦虑、抑郁状态及生活质量的调查分析

Anxiety,depression and quality of life investigation in colorectal cancer patients after different treatments

目的：本研究探讨不同的治疗模式对结直肠癌患者抑郁、焦虑和生活质量的影响。方法选择114例肿瘤患者和67名患者伴侣为研究对象，所有患者均被诊断为结肠或直肠癌，且接受过以下三种治疗方式之一：手术治疗，手术加化疗或者手术加放疗，并按照接受的治疗手段将患者与其伴侣一同分为三组，使用医院焦虑评定抑郁量表、癌症生活质量量表对患者的焦虑、抑郁程度进行评测，采用 Beck 抑郁量表对患者伴侣抑郁程度进行评价，将三组评价结果进行统计学分析。结果接受不同治疗方法结直肠癌患者的焦虑及抑郁程度差异有统计学意义（P ＜0．05）。接受手术及化疗的患者、手术及放疗患者的焦虑及抑郁程度与单纯接受手术的患者相比，焦虑及抑郁程度更高，差异有统计学意义（P ＜0．05）。手术及放疗的患者与手术加化疗的患者在焦虑及抑郁程度上差异无统计学意义（P ＞0．05）。接受不同治疗方法结直肠癌患者伴侣的焦虑及抑郁程度比较差异无统计学意义（P ＞0．05）。患者的抑郁水平越高，患者伴侣的抑郁水平也越高。焦虑和抑郁是患者生活质量的主要预测因子。结论这项研究强调了癌症患者及伴侣的心里干预的重要性。接受放化疗的患者及诊断超过12个月的患者是焦虑、抑郁的高危人群，应该重点给予心理干预。

Objective This study aimed to investigate the impact of different modes of treatments on depression,anxiety and quality of life in colorectal cancer patients.Methods The sample was comprised of 1 1 4 oncology patients and 67 partners of the oncology patients.All patients were diagnosed with colon cancer or rectal cancer.All of them accepted one of the three modes of treatments：surgery,surgery plus chemotherapy or surgery followed by radiotherapy.According to the treatments,the patients and their partners were divided into three groups.Anxiety and depression levels of the patients were evaluated with HADS,QOL-CA2.The depression level of their partners was evaluated with BDI.The evaluation results of the three groups were statistically analyzed.Results Anxiety and depression levels of colorectal cancer patients accepting different treatments were significantly different （P 〈0.05）.Compared to the patients accepting only surgery,anxiety and depression levels of the patients accepting surgery plus chemotherapy and the patients accepting surgery followed by radiotherapy were significantly higher （P 〈0.05）.Significant difference of anxiety and depression levels was not found between the patients accepting surgery followed by radiotherapy and the patients accepting surgery plus chemotherapy （P 〉0.05 ）.No significant difference of anxiety and depression levels was found among the partners of the patients accepting different treatments （P 〉0.05 ）.The higher the depression level of the patients were,the higher the depression level of their partners were.Anxiety and depression were the main predictors of patient′s quality of life.Conclusions This study highlights the importance of providing psychological interventions for cancer patients and their partners.The patients,who accept chemotherapy or radiotherapy and are diagnosed with cancer more than 1 2 months,are at high risk of anxiety and depression. Psychological interventions should be emphasized in these patients.