抑郁、焦虑情绪对肝癌术后患者认知功能的影响

Effect of depression and anxiety on cognitive function of patients with liver cancer after operation

目的探讨肝癌术后患者合并抑郁、焦虑情绪与认知功能障碍发生的关系。方法选取2016年1月—2019年1月在广西医科大学第四附属医院肝胆外科住院手术的120例肝癌患者为研究对象,于手术前后采用成套认知神经心理学测验(连线测验、符号测验、霍普金斯词汇学习-修订版、简单视觉记忆测试修订版、Stroop色词测试、持续操作测验)以及抑郁自评量表(SDS)、焦虑自评量表(SAS)进行调查,了解患者的认知功能及抑郁、焦虑情绪情况,比较术后合并抑郁、焦虑情绪以及非合并抑郁、焦虑情绪患者的认知功能,探讨抑郁、焦虑情绪对术后认知功能的影响。结果120例肝癌患者在评估时脱落6例,故共有114例患者完成调查。肝癌患者术后抑郁情绪检出率为40.35%,焦虑情绪检出率为31.58%。术后,合并抑郁、焦虑情绪患者的连线测验时间长于非合并抑郁、焦虑情绪的患者,而符号编码、霍普金斯词语学习测验、简易视觉记忆测验、色词测验、持续操作测验成绩低于非合并抑郁、焦虑情绪的患者,差异有统计学意义(P<0.05)。术后患者的抑郁、焦虑情绪与连线测验时间呈正相关,与符号编码、霍普金斯词语学习测验、简易视觉记忆测验、色词测验、持续操作测验成绩呈负相关(P<0.05)。结论肝癌手术后合并抑郁、焦虑情绪患者存在总体认知功能下降,推测抑郁、焦虑情绪可能进一步加重肝癌术后认知功能障碍。

Objective To explore the relationship between depression,anxiety and cognitive dysfunction in patients with liver cancer after operation.Methods A total of 120 patients with liver cancer who underwent inpatient operations in the Department of Hepatobiliary Surgery in the Fourth Affiliated Hospital of Guangxi Medical University from January 2016 to January 2019 were selected as the research subjects.Patients were examined before and after operation using a set of cognitive neuropsychological tests(including line connect test,symbol test,Hopkins vocabulary learning-revised version,simple visual memory test-revised version,Stroop color word test,continuous performance test),self-rating depression scale(SDS),and self-rating anxiety scale(SAS)in order to understand the cognitive function,depression and anxiety.The cognitive function of patients with depression,anxiety and patients without depression and anxiety after operation were compared,and the effect of depression and anxiety on postoperative cognitive function was explored.Results Of the 120 patients with liver cancer,6 were shed at the time of evaluation,so a total of 114 patients completed the survey.The detection rates of depression and anxiety were 40.35%and 31.58%respectively.After surgery,patients with depression and anxiety had longer time of the line connect test than patients without depression and anxiety,and had lower scores of symbol test,Hopkins vocabulary learning-revised version,simple visual memory test-revised version,color word test,continuous performance test than patients without depression and anxiety,the differences were statistically significant(P<0.05).The depression and anxiety of patients after operation were positively correlated with the time of the line connect test,and were negatively correlated with the result of symbol coding test,Hopkins vocabulary learning test,simple visual memory test,color word test,continuous performance test(P<0.05).Conclusion Patients with depression and anxiety after liver cancer surgery have overall cognitive decline.It is speculated that depression and anxiety may further aggravate cognitive dysfunction after liver cancer surgery.