摘要
目的:分析喉癌术后患者的心理特征,比较不同术式喉癌患者心理状态差异。方法:2002-01/2004-01在辽宁省肿瘤医院头颈外科接受手术治疗的喉癌患者136例。根据患者手术方式的不同,分为全喉切除组(n=52)和部分喉切除组(n=84),选择到头颈外科病房探视患者的正常人136例为对照组。采用问卷调查法:①症状自评量表测定调查对象的心理健康水平,采用5级评分,各项得分越高,精神症状越多(总分≥160分),表明心理健康水平越差。②Zung抑郁自评量表、Zung焦虑自评量表评估患者的抑郁及焦虑状况,均为4级评分(1～4),界定值50分,得分越高,表明抑郁及焦虑程度越重。主要观察不同术式患者症状自评量表,Zung抑郁自评量表,Zung焦虑自评量表评分结果,并与正常对照组进行比较,样本间比较采用t检验。结果:所有调查对象全部进入结果分析,无脱落。①各组症状自评量表评分比较:全喉切除与部分喉切除患者症状自评量表评分总分≥160分者分别为35例(67.3%),40例(47.6%)。除焦虑因子外,全喉切除组症状自评量表总分及其他因子分均高于部分喉切除组(t=2.120～3.778,P<0.001～0.05),两组症状自评量表总分及其他所有因子分均显著高于对照组(t=2.042～8.388,P<0.001～0.05)。②各组Zung焦虑自评量表、Zung抑郁自评量表评分比较:全喉切除组Zung焦虑自评量表得分及Zung抑郁自评量表得分≥50分者,分别为30例(57.7%),40例(76.9%),部分喉切除组两量表得分≥50分者分别为51例(60.7%),41例(48.8%)。全部喉切除组患者Zung抑郁自量表标准分均值明显高于部分喉切除组(t=2.816,P<0.01),全喉切除组与部分喉切除组Zung焦虑自评量表、Zung抑郁自量表标准分均值均显著高于对照组(t=3.159-6.462,P<0.01)。结论:喉癌术后患者的心理健康状况较差,全喉切除术后患者的心理问题及抑郁情绪较部分喉切除术后患者严重,为提高患者生存质量,外科治疗方面应尽量行部分喉切除术,术后应及时对不同术式患者有区别地进行心理干预。
AIM： To analyze the psychological characteristics in postoperative patients with larynx carcinoma, and compare the difference of mental status in patients treated with different laryngectomies. METHODS： Totally 136 patients with larynx carcinoma, who were treated with operation in the Department of Head-Neck Surgery, Liaoning Provincial Tumor Hospital from January 2002 to January 2004, were divided into total larygeetomy group （n=52） and partial larygectomy group （n=84.） according to the different methods of operation. Their mental health level was aseesed with symptom checklist-90 （SCL-90） by 5-degree scoring system, the higher the score, the more the psychiatric symptoms （total score ≥160 points）, indicating that the mental health level was worse. Their depressive and anxious status were evaluated with self-rating depression scale （SDS） and self-rating anxiety scale （SAS） designed by Zung, scored by 4 grades （1-4）, the delimitation value was 50 points, the higher the score, the severer the severity of depression and anxiety. The scores of SCL-90, SDS and SAS were mainly observed, and compare with the normal control group, and the t test was applied in the comparison of the samples. RESULTS： All the subjects were involved in the analysis of results without deletion. ① Comparison of SCL-90 scores： The number of cases had the total score ≥160 for SCL-90 in the total laryngectomy group and partial laryngectomy group was 35 （67.3%） and 40 （47.6%） respectively. Except anxiety, the total score and other factor scores of SCL-90 were al higher in the total laryngectomy group than in the partial laryngectomy group （t=2.120-3.778, P〈0.001-0.05）. The total score and other factor scores of SCL-90 in the two laryngectomy groups were all significantly higher than those in the control group （t=2.042-8.388, P〈0.001-0.05）. ② Comparison of the scores of SDS and SAS： The score of SDS and SAS in the total laryngectomy group was ≥50 points in 30 cases （57.7%） and 40 cases （76.9%）. The score of SDS and SAS in the partial laryrtgectomy group was ≥50 points in 51 cases （60.7%） and 41 cases （48.8%）. The standard score of SDS in the total laryngectomy group was obviously higher than that in the partial laryngectomy group （t=2.816, P〈0.01）. The standard scores of SAS and SDS were all significantly higher in the total and partial laryngectomy groups than in the control group （t=3.159-6.462, P〈0.01）. CONCLUSION： The mental health status of post-laryngectomy patients is bad. The mental problems and depression in patients received total laryngee tomy are worse than those in the cases of partial laryngectomy. In order to im prove the living quality of the patients, partial laryngectomy should be recom mended, and different psychological interference should be given for different laryngectomies.
出处
《中国临床康复》
CSCD
北大核心
2005年第40期56-58,共3页
Chinese Journal of Clinical Rehabilitation
