癌症幸存者失眠的相关影响因素分析

Clinical Research on Factors Related to Insomnia in Cancer Survivors

目的探讨癌症幸存者(CS)的癌因性失眠(CRI)现状及其相关影响因素。方法选择2016年3月~2016年8月在海军总医院中医科就诊的83名CS(已完成常规治疗如手术、放化疗超过6个月,进入随访期的患者)进行问卷调查,使用ICSD-3诊断慢性失眠,使用自制肿瘤调查问卷调查CS基本情况及既往病史,使用匹兹堡睡眠质量量表(PSQI)测评CS睡眠情况。结果 83例患者中,42例诊断为慢性失眠,CRI的发生率为50.6%(42/83),仅有12例曾经接受过专业的失眠治疗。患者的PSQI与末次有创治疗时间间隔呈负相关(r=-0.37,P<0.05);二元logistic回归分析显示,患者性别、年龄、肿瘤类型、病程时长、慢性病与失眠不相关,仅患者末次有创治疗时间间隔与失眠呈负相关(r=-0.034,P<0.05)。结论慢性失眠在CS中发病率较高,重视程度及治疗不够,随着末次有创治疗时间间隔的延长,CS的失眠严重程度逐渐降低。

Objective To research the situation of cancer-related insomnia （CRI） and the treatment of cancer survivors （CS）, and inves- tigate the related affecting factors. Methods We selected 83 CS who received treatment in TCM Department of Navy General Hospital from March, 2016 to August, 2016. All the CS had finished regular therapy like surgery, radiotherapy or chemotherapy more than six months. We diagnosed the subjects insomnia with ICSD-3, assessed their sleep quality with Pittsburgh sleep quality index （PSQI）, and collected their basic information and medical history with normal questionnaire. Results A total of 83 patients were included in this study, and 42 of them were diagnosed as insomnia. The morbidity of CRI was 50.6%. Only 12 patients had received professional insomnia therapy. All of the subjects had received at least one kind of invasive treatment, 61 with surgery, 58 with chemotherapy, and 40 with radiotherapy. We found a negative correlation between time interval to the last invasive treatment and the PSQI scores with Pearson analysis （r=--0.37, P〈0.05）. The binary logistic regression also showed a negative correlation between the time intervals to the last invasive treatment and insomnia, but that age, sex, tumor types, course of disease, chronic disease were not related to insomnia. Conclusion There was a high morbidity of insomnia for CS, but CS did not get enough attention or treatment. With the time interval to the last invasive treatment prolonged, the severity of in- somnia decreases gradually.