甲状腺癌根治术患者术后癌因性疲乏影响因素及干预措施分析

Analysis of influencing factors and intervention measures of cancer-related fatigue in patients undergoing radical thyroidectomy

目的:探讨甲状腺癌根治术患者术后癌因性疲乏(CRF)影响因素,制订相关干预措施,并分析干预效果。方法:选取2020年3月—2023年1月甲状腺癌患者82例为对照组,根据CRF发生情况分为CRF组及非CRF组,分析影响患者术后出现CRF的危险因素,并根据危险因素制订针对性干预措施;选取2023年2月—2023年10月甲状腺癌根治术患者50例为干预组进行干预,分析该措施对患者CRF的影响。结果:CRF组中贫血、术后促甲状腺素(TSH)水平≥0.5 mU/L、抑郁、焦虑、睡眠障碍的人数比例高于非CRF组,术后放射线碘治疗的人数比例低于非CRF组(P<0.05)。贫血、术后TSH水平≥0.5 mU/L、抑郁、焦虑、睡眠障碍是甲状腺癌根治术患者术后CRF发生的危险因素,术后放射线碘治疗为保护因素(P<0.05)。干预组CFS评分躯体疲乏、情感疲乏评分及总分低于对照组(P<0.05)。干预组焦虑自评量表(SAS)、抑郁自评量表(SDS)、匹兹堡睡眠质量指数(PSQI)评分低于对照组(P<0.05)。结论:贫血、术后TSH抑制水平降低及抑郁、焦虑、睡眠障碍是甲状腺癌根治术患者术后出现CRF的影响因素,针对各危险因素制订相关干预措施,可减轻CRF程度,改善患者焦虑、抑郁及睡眠障碍情况。

Objective:To explore the influencing factors of cancer-related fatigue(CRF) in patients undergoing radical thyroidectomy,formulate the related intervention measures,and analyze the intervention effect.Methods:All 82 patients with thyroid cancer from March 2020 to February 2023 were selected as the study subject(control group) and were divided into CRF group and non-CRF group according to the occurrence of CRF.The risk factors affecting postoperative CRF were analyzed,and targeted intervention measures were developed according to the risk factors.50 patients undergoing radical thyroidectomy from February 2023 to October 2023(intervention group) were intervened to analyze the effect of this measure on the occurrence of CRF in patients.Results:The proportion of people with anemia,postoperative thyroid-stimulating hormone(TSH) level≥0.5 mU/L,depression,anxiety and sleep disorder in CRF group were higher than those in non-CRF group while the proportion of people with postoperative radioiodine therapy was lower than that in non-CRF group(P<0.05).Anemia,postoperative TSH level≥0.5 mU/L,depression,anxiety and sleep disorder were the risk factors for postoperative CRF in patients undergoing radical thyroidectomy,and postoperative radioiodine therapy was the protective factor(P<0.05).Cancer fatigue scale of physical fatigue,emotional fatigue and total scores in intervention group were lower than those in control group.The scores of Self-rating anxiety scale(SAS),self-ratingdepression scale(SDS) and pittsburgh sleep quality index(PSQI) in the intervention group were lower than those in the control group.Conclusion:Anemia,reduced postoperative TSH inhibition,depression,anxiety and sleep disorder are the influencing factors for postoperative CRF in patients with radical thyroidectomy.According to the related intervention measures for various risk factors,the analysis finds that the intervention measure can relieve the CRF degree and improve the anxiety,depression and sleep disorder of patients.