肺癌患者术后抑郁症状轨迹识别研究

Study on trajectory recognition of postoperative depressive symptoms in patients with lung cancer

目的探讨肺癌患者术后抑郁症状轨迹识别研究方法。方法选择2015年11月~2016年2月在我院住院的肺癌术后患者150例为研究对象,先建立人口学资料数据库并采用心理问题评估,其中A组为空白干预,即未对患者可能存在的心理问题进行任何医学处理,B组(对照组)实施常规心理干预,C组(观察组)则进行综合的心理干预,主要以医师为主导,主动结合精神科专业医师意见及建议进行心理相关评估与干预,更好地评估并改善患者心理状况,确定肺癌患者发生的各种心理症状之间的相互关系。结果各组内增长曲线之间存在一定差异,不同评分量表所示各组内增长曲线之间差异无统计学意义,术后A组患者发生焦虑及抑郁的可能性随着时间的延长呈上升趋势,B组随着时间的延长,其焦虑与抑郁的发生率基本稳定,C组随着时间的延长,其焦虑与抑郁的发生率呈现下降趋势。干预后观察组HAMD和HAMA评分均低于干预前,且干预后观察组HAMD和HAMA评分低于对照组(P<0.05),观察组3个月、6个月及9个月生存率均显著高于对照组。结论不同量表在评价肺癌患者术后焦虑及抑郁情况方面具有的效果基本相同,而患者焦虑及抑郁较常发生于术后3个月,同时实施有效的综合干预对于减轻患者术后焦虑抑郁有重要价值。

Objective To investigate the method of trajectory recognition of postoperative depressive symptoms in patients with lung cancer. Methods A total of 150 patients with postoperative lung cancer who were hospitalized from November 2015 to February 2016 were selected as the study subjects. First, the database of demographic data was established and the psychological assessment was used. Group A was blank intervention group, that was, no medical measurement was taken for the patient＇s possible psychological problems. Group B（control group）was treated with routine psychological intervention. And group C was treated with comprehensive psychological intervention for psychological correlation assessment and intervention,with physician-led mainly, actively combined with psychiatric professional physician opinion and suggestions,to better assess and improve the psychological status of patients and to determine the relationship between the various psychological symptoms of lung cancer patients. Results There were some differences between the growth curves in each group. There was no significant difference between the growth curves showed in the different score scales. The possibility of anxiety and depression in group A patients increased with time.The incidence of anxiety and depression was stable in group B over time, and the incidence of anxiety and depression in group C decreased with time. The HAMD and HAMA scores of the observation group after intervention were lower than those before intervention, and the HAMD and HAMA scores of the observation group were lower than those of the control group （P〈0.05）. The survival rates of 3 months, 6 months and 9 months in the observation group were significantly higher than those of the control group. Conclusion Different scales have the same effect in assessing postoperative anxiety and depression in patients with lung cancer.While the anxiety and depression of patients occur more frequently at 3 months after surgery.At the same time the implementation of effective integrated interventions has significant value in reducing postoperative anxiety and depression in patients.