脑胶质瘤患者围术期抑郁与焦虑状况及其影响因素

Perioperative Depression and Anxiety in Patients with Glioma and their Influencing Factors

【目的】探讨脑胶质瘤患者围术期抑郁与焦虑状况及其影响因素。【方法】回顾性分析2016年1月至2018年1月本院收治的104例行择期手术治疗的脑胶质瘤患者的临床资料,记录术前、术后相关指标,术前指标包括肿瘤部位、术前化疗情况、术前3 d的血清血管内皮细胞生长因子(VEGF)水平、拟定手术方式,术后指标包括脑胶质瘤病理分级、疲劳程度、术后次日血清VEGF水平,采用单因素分析、多变量回归分析脑胶质瘤患者围术期焦虑、抑郁的影响因素。【结果】单因素分析显示,不同年龄、性别、病程、婚姻状况、文化程度、复发情况、肿瘤部位、术前及术后血清VEGF水平、手术方法、脑胶质瘤病理分级、术后疲乏程度患者术后的焦虑、抑郁评分低于术前,差异均有统计学意义(P<0.05)。多变量回归分析显示,脑胶质瘤患者术前焦虑的影响因素为已婚、脑胶质瘤高分级(P<0.05);术前抑郁的影响因素为术前血清VEGF水平≥56 pg/mL、肿瘤位于额颞叶(P<0.05);术后焦虑的影响因素为已婚、脑胶质瘤高分级(P<0.05);术后抑郁的影响因素为女性、脑胶质瘤高分级(P<0.05)。【结论】脑胶质瘤患者围术期焦虑、抑郁的影响因素为已婚、脑胶质瘤高分级、术前血清VEGF水平≥56 pg/mL、肿瘤位于额颞叶、女性,临床医护人员需对存在上述影响因素的患者予以关注。

【Objective】To explore the status of depression and anxiety in patients with glioma during perioperative period and its influencing factors.【Methods】The clinical data of 104 patients with gliomas who received elective surgery from January 2016 to January 2018 were retrospectively analyzed,and the preoperative and postoperative related indicators were recorded.The preoperative indicators included tumor site,preoperative chemotherapy,level of serum vascular endothelial growth factor(VEGF)3 days before surgery and the proposed surgical form.The postoperative indicators included pathological grade of gliomas,fatigue degree,and serum VEGF level the next day after surgery,Univariate analysis and multivariate regression were used to analyze the influencing factors of anxiety and depression in patients with glioma during perioperative period.【Results】Single factor analysis showed that the scores of anxiety and depression of patients with different age,sex,course of disease,marital status,educational level,recurrence,tumor site,preoperative and postoperative serum VEGF level,surgical method,pathological grade of glioma,and postoperative fatigue were lower than those before surgery,and the differences were statistically significant(P<0.05).Multivariate regression analysis showed that the influencing factors of preoperative anxiety in patients with glioma were marriage and high grade of glioma(P<0.05).The influencing factors of preoperative depression were serum VEGF level≥56 pg/mL and frontotemporal lobe(P<0.05).The influencing factors of postoperative anxiety were marriage and high grade of glioma(P<0.05).The influential factors of postoperative depression were women and high grade of glioma(P<0.05).【Conclusion】The influencing factors of anxiety and depression in patients with brain glioma during perioperative period are marriage,high grade of glioma,preoperative serum VEGF level≥56 pg/mL,frontotemporal lobe and female.Clinical medical staff should pay attention to the patients with the above influencing factors.