复杂性肾结石患者双通道经皮肾镜术后焦虑、抑郁情况及其影响因素

Status and influencing factors of anxiety and depression in patients with complex renal calculi after dualchannel percutaneous nephroscopy

目的研究复杂性肾结石患者双通道经皮肾镜术后焦虑、抑郁状况及其影响因素。方法选取2019年1月~2022年1月在我院行双通道经皮肾镜手术的256例复杂性肾结石患者,术后采用医院焦虑抑郁量表评估,根据评分结果将患者分为焦虑组与无焦虑组、抑郁组与无抑郁组,收集患者临床资料,采用单因素、多因素Logistic回归分析复杂性肾结石患者双通道经皮肾镜术后发生焦虑、抑郁的影响因素。结果256例复杂性肾结石双通道经皮肾镜术后患者中焦虑、抑郁症状检出率分别为28.52%(73/256)、23.05%(59/256),患者手术前焦虑、抑郁评分均低于手术后(P<0.05);单因素、多因素Logistic回归分析显示,居住地(农村)、月收入(<3000元)、付费方式(自费/新农合)、有糖尿病是患者术后发生焦虑的危险因素(P<0.05);女性、文化程度(小学及以下)、居住地(农村)、婚姻状况(离异/丧偶)、月收入(<3000元)、有术后并发症是术后发生抑郁的危险因素(P<0.05)。结论复杂性肾结石患者双通道经皮肾镜术后焦虑、抑郁发生率较高,并且受多种因素影响,临床上应采取有针对性的措施预防术后焦虑、抑郁的发生。

Objective To study the status and influencing factors of anxiety and depression after dual-channel percutaneous nephroscopy in patients with complex renal calculi.Methods 256 patients with complex renal calculi who underwent dual-channel percutaneous nephroscopic surgery in the hospital from January 2019 to January 2022 were selected.Hospital Anxiety and Depression Scale was used for evaluation after surgery,and the patients were divided into anxiety group and non-anxiety group,depression group and non-depression group by means of the score.The clinical data of patients were collected,and univariate analysis and multivariate Logistic regression analysis were adopted to analyze the influencing factors of occurrence of anxiety and depression in patients with complex renal calculi after dual-channel percutaneous nephroscopy.Results The rates of anxiety and depression were 28.52%(73/256)and 23.05%(59/256)among 256 patients with complex renal calculi after dual-channel percutaneous nephroscopy,and the scores of anxiety and depression before surgery were lower than those after surgery(P<0.05).Univariate analysis and multivariate Logistic regression analysis showed that place of residence(rural area),monthly income(<3000 yuan),payment method(selfpay/new rural cooperative medical system)and presence of diabetes mellitus were the risk factors for postoperative anxiety(P<0.05).Female,educational level(primary school and helow),place of residence(rural area),marital status(divorced/widowed),monthly income(<3000 yuan),and postoperative complications were risk factors for postoperative depression(P<0.05).Conclusion The incidence rates of anxiety and depression are high after dual-channel percutaneous nephroscopy in patients with complex renal calculi,and they are affected by many factors.Clinically,it is necessary to take targeted measures to prevent the occurrence of postoperative anxiety and depression.