摘要
目的比较腹腔镜手术和开腹手术宫颈癌患者手术前后的抑郁、焦虑和生存质量,为有针对性地对宫颈癌患者进行心理干预提供参考依据。方法于2015年1月—2016年7月在中国医科大学附属肿瘤医院和附属盛京医院随机抽取49例行腹腔镜根治术(腹腔镜组)和51例行开腹根治术(开腹组)的宫颈癌患者进行问卷调查。结果术前开腹组与腹腔镜组宫颈癌患者比较,2组患者抑郁、焦虑和生存质量得分差异均无统计学意义(均P>0.05);术后2个月和术后6个月开腹组与腹腔镜组宫颈癌患者比较,开腹组患者生存质量得分分别为(67.92±14.40)和(72.46±14.62)分,均低于腹腔镜组患者的(78.22±11.88)和(93.90±8.08)分(均P<0.05);术前、术后2个月和术后6个月比较,腹腔镜组患者抑郁、焦虑、生存质量得分和开腹组患者焦虑、生存质量得分差异均有统计学意义(均P<0.05);术前腹腔镜组和开腹组患者抑郁(89.8%和90.2%)、焦虑(91.8%和80.4%)、抑郁焦虑共病症状(81.6%和74.5%)检出率均处于较高水平,术后2个月和术后6个月与术前比较,抑郁、焦虑和抑郁焦虑共病检出率差异均无统计学意义(均P>0.05)。结论腹腔镜组宫颈癌患者术后2个月和术后6个月生存质量高于开腹组患者,且腹腔镜组宫颈癌患者术后6个月抑郁和焦虑水平降低,生存质量提高。
Objective To compare statuses of depression, anxiety and quality of life among cervical cancer patients before and after laparoscopic or laparotomic surgery approaches and to provide references for implementing targeted psychological interventions in the patients. Methods We randomly selected 49 and 55 cervical cancer patients with laparoscopic and laparotomic radical resection during the period from January 2015 to July 2016 in two affiliated hospitals of China Medical University; then we conducted questionnaire surveys in the patient before, 2 months and 6 months after the surgeries using Center for Epidemiological Survey-Depression Scale (CES-D), Self-Rating Anxiety Scale (SAS), and Functional Assessment of Cancer Therapy-Cervix (FACT-Cx). Analysis of variance and Chi-square test were adopted in data analyses. Results No significant differences in scores for depression, anxiety, and quality of life were observed between the inpatients of the two groups (P 〉 0.05 for all). However, significantly lower FACT-Cx scores were observed among the patients with laparotomic surgery than among those with laparoscopic surgery at 2-month (67.92 ±14.40 vs. 78.22 ±11.88) and 6-month (72.46 ±14.62 vs. 93.90 ±8.08) after the surgery (both P 〈 0.05). Six months after the surgery, the scores for depression, anxiety, and quality of life among the patients with laparoscopic operation and the scores for anxiety and quality of life among the patients with laparotomic operation differed significantly compared to those of before and 2 months after the surgery (all P 〈 0.05). Higher prevalence rates of depression, anxiety, and the comorbidity of depression and anxiety were detected among the patients with laparoscopic operation (89.8%, 91.8%, and 80.4%) and the patients with laparotomic operation (90.2%, 80.4%, and 74.5%) before the surgery; while all the rates did not vary significantly at 2-month and 6-month after the surgery in comparison with those before the surgery (all P 〉 0.05). Conclusion The cervical cancer patients with laparoscopic radical resection had a better quality of life than those with laparotomic radical resection at 2-month and 6-month after the surgery and the formers' depressive and anxious condition alleviated but the quality of life upgraded at 6-month after the surgery.
作者
刘运泳
郑芳园
王丹波
LIU Yun-yong, ZHENG Fang-yuan, WANG Dan-bo(Office for Cancer Prevention and Control in Liaoning Province, Liaoning Provincial Cancer Hospital, Cancer Hospital of China Medical University, Shenyang, Liaoning Province 110042, Chin)
出处
《中国公共卫生》
CAS
CSCD
北大核心
2018年第3期445-447,共3页
Chinese Journal of Public Health
基金
国家重点研发计划数字诊疗装备研发重点专项(2017YFC0114204)
辽宁省自然科学基金(2015020261)
关键词
宫颈癌
腹腔镜根治术
开腹根治术
抑郁
焦虑
生存质量
cervical cancer laparoscopic radical resection laparotomic radical resection depression anxiety quality of life