肝癌患者经动脉化疗栓塞术治疗后心理痛苦水平调查及影响因素分析

The investigation of psychological distress and the analysis of influence factors in patients with hepatocellular carcinoma treated by transcatheter arterial chemoembolization

目的:研究接受肝癌(HCC)经动脉化疗栓塞(TACE)治疗患者心理痛苦水平及其影响因素。方法:纳入我院70例接受TACE治疗的HCC患者作为研究对象,采用心理痛苦温度计(DT)评估TACE治疗患者的心理痛苦水平,根据DT评分将患者分为心理痛苦组和非心理痛苦组,采用Logistic多因素分析影响患者心理痛苦的独立因素。结果:70例接受TACE治疗的HCC患者DT为(4.52±2.69)分;非心理痛苦18例,占25.71%,心理痛苦52例,占74.29%。其中明显心理痛苦者36例,占51.43%,重度16例,占22.86%。Logistic多因素分析显示文化程度、肿瘤分期分化程度、焦虑抑郁状态是心理痛苦水平的危险因素(OR=2.337,3.874,2.214,7.683,4.293;P=0.000,0.000,0.002,0.028,0.012),收入水平和睡眠质量是心理痛苦水平的保护因素(OR=0.212,0.356;P=0.000,0.005)。结论:接受TACE治疗的HCC患者普遍存在心理痛苦现象,文化程度、肿瘤分期分化程度、焦虑抑郁是心理痛苦的危险因素,收入水平和睡眠质量是心理痛苦的保护因素。

Objective：To study the psychological distress and the analysis of ilffluence factors in patients with hepatocellular carcinoma （HCC） treated by transcatheter arterial chemoembolization （TACE）. Methods ：70 patients with HCC treated with TACE were included in this study. The distress thermometer（DT） was used to assess the level of psychological distress in TACE patients, the patients were divided into psychological pain group and non psychological pain group accorded to the DT score. The logistic multivariate analysis was used to the inde- pendent factors of psychological pain in those patients. Results ： The DT were （4.52 ± 2.69） scores in 70 patients with HCC treated with TA- CE. There were 18 cases of non psychological pain,accounted for 25.71% and 52 cases of psychological pain, accounted for 74.29%. There were 36 cases of obvious psychological pain, accounted for 51.43% , 16 cases of seriously,accounted for 22.86%. The logistic multivariate a- nalysis showed that educational level, stage of tumor, degree of differentiation, anxiety and depression were the risk factors of psychological dis- tress（ OR =2. 337,3. 874,2. 214,7. 683,4. 293 ;P = 0. 000,0. 000,0. 002,0. 028,0. 012）. The wages and sleep quality- were protective fac- tors for psychological pain levels（ OR = 0.212,0. 356 ;P = 0. 000 , 0. 005 ） . Conclusion ：The patients of HCC treated by TACE have psycholog- ical pain phenomenon generally. The culture degree, tumor stage, differentiation, anxiety and depression are risk factors of psychological dis- tress, the wages level and quality- of sleep were protective factors of psychological pain.