乳腺癌患者手术前后生存质量与焦虑抑郁状况调查研究

Investigation on quality of life and anxiety and depression in patients with breast cancer before and after surgery

目的调查影响乳腺癌患者手术前、治疗期及康复期生存质量与焦虑抑郁状况的相关危险因素,为临床治疗提供依据。方法选取2015年1~12月于浙江省人民医院甲状腺乳腺外科进行手术并且经病理确诊的乳腺癌患者为调查对象。选用QLQ-BR53量表进行调查研究,分别于术前、术后6个月、术后12个月对符合条件的168例乳腺癌患者进行面对面问卷调查;选取焦虑自评量表(SAS)和抑郁自评量表(SDS)对乳腺癌患者焦虑抑郁调查,观察乳腺癌患者手术前、治疗期及康复期生存质量评分、焦虑抑郁情绪变化情况。评分经标化后录入SPSS 19.0软件,采用ANOVA检验。结果 PF、RF、EF、SF、QL、NV、DI领域均于术后6个月出现最低值,术后12个月有所恢复,但评分较术前仍较低;FA、CF领域评分随时间一直下降;DY、AP领域评分随时间逐渐升高。3个时期的QLQ-BR53、SAS、SDS各项评分比较,差异有统计学意义(P<0.05)。结论乳腺癌患者术后面临生存质量欠佳、焦虑抑郁状况明显的问题,患者的生存质量随其焦虑抑郁状况加重而降低。为缓解患者术后焦虑抑郁,更好地提高整体生存质量,医务人员需要提早、全面地干预各种可能出现和发生的病理状况。

Objective To investigate the risk factors of quality of life and anxiety and depression in patients with breast cancer before surgery, during treatment period and rehabilitation period, and to provide the basis for clinical treatment.Methods Breast cancer patients who underwent surgery and were pathologically diagnosed in Zhejiang Provincial People's Hospital from January to December 2015 were investigated. QLQ-BR53 scale was used to conduct a face-to-face questionnaire on 168 eligible patients with breast cancer before surgery, at 6 months and 12 months after operation. The self-rating anxiety scale(SAS) and the self-rating depression scale(SDS) were used to investigate the status of anxiety and depression in breast cancer patients. The changes of quality of life, anxiety and depression in patients with breast cancer before surgery, during treatment period and rehabilitation period were observed. The scores were recorded into SPSS 19.0 software after standardizing, and ANOVA test was used. Results PF, RF, EF, SF, QL, NV and DI were the lowest at 6 months after surgery. The scores were restored at 12 months after surgery, but the scores were still lower than those before surgery. The scores of FA and CF fields were declining over time. The scores of DY and AP fields gradually increased over time. There were significant differences in the scores of QLQ-BR53, SAS and SDS among the three periods(P<0.05). Conclusion Patients with postoperative breast cancer are faced with problems of poor quality of life and obvious anxiety and depression after surgery. The quality of life of patients with breast cancer is reduced with the increase of anxiety and depression. In order to alleviate the postoperative anxiety and depression of patients and better improve the overall quality of life, medical personnel need to intervene early and comprehensively the pathological conditions that may appear and occur.