136例口腔癌皮瓣重建术后辅助放疗患者抑郁状况及影响因素分析

Depression status of 136 patients with adjuvant radiotherapy after reconstruction of the oral cancer flap and analysis of influencing factors

目的探讨口腔癌皮瓣重建术后辅助放疗患者的抑郁情况及影响因素,为术后护理提供依据。方法选取哈尔滨医科大学附属的4家医院的口腔癌皮瓣重建术后辅助放疗患者136例,收集患者的一般资料、抑郁自评量表评估抑郁情况、问卷评估症状困扰情况,用多元逐步回归统计分析确定抑郁情况及影响因素。结果口腔癌皮瓣重建术后辅助放疗患者的抑郁得分平均为(52.32±13.11)分,33.1%患者为轻度抑郁,21.3%患者为中度抑郁,2.2%患者为重度抑郁;术后患者存在疼痛、吞咽困难、味觉障碍、颞下颌关节和唾液腺功能损伤等症状以及婚姻、经济等困扰因素。分析结果显示,吞咽困难(P<0.001)、味觉障碍(P<0.001)、婚姻状况(P=0.004)、家庭人均月收入(P=0.011)可成为口腔癌放疗期患者出现抑郁情况的影响因素,二者具有明显的相关性。结论口腔癌皮瓣重建术后辅助放疗患者多存在抑郁症状,会严重影响生活质量,因此对此类患者的护理应关注和改善患者的术后抑郁情况。

Objective To explore the depression and influencing factors of patients with adjuvant radiotherapy after reconstruction of oral cancer flaps and to provide evidence for postoperative care.Methods One hundred thirty-six patients with oral cancer who had undergone adjuvant radiotherapy after reconstruction of skin flaps at 4 affiliated hospitals in Harbin Medical University were selected by convenience sampling.The basic information of the patients with adjuvant radiotherapy after reconstruction of skin flaps was collected,a self-rating scale for depression was used to assess depression,and a questionnaire was used to assess symptom distress.Depression and its influencing factors were determined by multiple stepwise regression analysis.Results The average score of depression in patients with oral cancer after skin flap reconstruction was(52.32±13.11):33.1% of the patients showed mild depression,21.3%showed moderate depression,and 2.2% showed severe depression.Postoperatively,the patients had pain,dysphagia,taste disorders,temporomandibular joint and salivary gland dysfunction,as well as marital and financial problems.The results showed that dysphagia(P<0.001),taste disorder(P<0.001),marital status(P=0.004)and family income per month(P=0.011)could be the influencing factors of depression in patients with oral cancer during radiotherapy,and a significant correlation was found between them.Conclusion Patients with adjuvant radiotherapy after reconstruction of oral cancer flaps have depressive symptoms,which will seriously affect the quality of life.Therefore,the care of such patients should focus on improving the postoperative depression of patients.