肝癌患者术前睡眠质量主客观评价指标相关分析

Correlation analysis between subjective and objective indexes of sleep quality in patients with liver cancer before surgery

目的探讨肝癌患者术前睡眠质量主、客观评价指标的相关性。方法采用方便抽样法，选取2014年10月—2016年3月西安交通大学医学院第一附属医院收治的肝癌患者78例为研究对象，采用匹兹堡睡眠质量指数（PSQI）量表、活动记录仪测量患者的主、客观睡眠质量指标，并对主、客观睡眠质量指标进行Pearson相关分析。结果患者术前PSQI总分为（9.4±4.1）分，其中主观睡眠质量较差49例，占62.8%；睡眠质量较好29例，占37.2%。患者客观睡眠时间（401.0±113.4）min，睡眠效率为810%，夜间觉醒次数为（3.5±2.1）次。客观睡眠潜伏期与PSQI总分及主观睡眠质量、睡眠潜伏期、睡眠效率、催眠药物使用4个维度呈低度正相关（r值分别为0.23，0.26，0.22，0.20，0.24；P〈0.05）；客观睡眠效率与PSQI睡眠障碍维度成低度负相关（r=-0.20，P〈0.05）；客观入睡后觉醒与PSQI催眠药物使用维度成低度正相关（r=0.31，P〈0.05）；客观夜间觉醒与PSQI催眠药物使用维度呈低度正相关（r=0.22，P〈005）。主观睡眠质量较好患者睡眠效率（80.1±17.9）%，睡眠质量较差患者睡眠效率（81.5±11.8）%，两组患者客观睡眠质量比较差异无统计学意义（t=-0.42，P〉0.05）。结论PSQI和活动记录仪的主、客观指标测量均表明肝癌患者睡眠质量较差，但主、客观指标相关程度低，主观评价结果与客观评价结果不全一致，提醒医护人员应采取主、客观相结合的方法评价肝癌患者的睡眠质量。

Objective To investigate the correlation between subjective and objective indexes of sleep quality in the patients with liver cancer before surgery. Methods Totally 78 patients with liver cancer in the First Affiliated Hospital of Xi＇an Jiaotong University from October 2014 to March 2016 were selected as the research object by convenience sample method. The Pittsburgh sleep quality index （PSQI） and actigraphy were used to evaluate the subjective and objective indexes of sleep quality. Pearson correlation analysis was used to analyze the subjective and objective indexes of sleep quality. Results The PSQI total score of participants before surgery was （9.4±4.1） and 49 cases （62.8%） were subjectively poor sleepers. 29 cases were good sleepers, which accounted for 37.2%. The objective sleep time of patients was （401.0± 113.4） min, the sleepefficiency was 81.0%, and the number of nocturnal awakenings was （3.5 ± 2.1 ）. Objective sleep onset latency was correlated with PSQI global score, subjective sleep quality, sleep latency, sleep efficiency, and daytime dysfunction （ r= 0.23,0.26,0.22,0.20,0.24 ;P〈0.05）. The objective sleep eefficiency was negative correlated with the PSQI sleep disorders （r=-0.20,P〈0.05） ; the objective awakenings after sleep onset was positively correlated with the use of PSQI hypnotic （r = 0.31, P〈 0.05）; and the objective nocturnal awakenings was positively correlated with the use of PSQI hypnotic （r= 0.22,P〈0.05）. The sleep efficiency of subjectively good sleepers was （80. 1± 17.9）%, while the sleep efficiency of poor sleepers was （81.5 ± 11.8） % （t =-0.42,P〉0.05）. Conclusions PSQI and the subjective and objective indexes of sleep quality all showed that, patients with liver cancer have poor sleep before surgery~ but the correlation between subjective index and objective index is low, and the dimensions to evaluate the subjective and objective indexes are not in accordance. It is important to evaluate the sleep of patients with liver cancer by combining the subjective and objective indexes together.