摘要
目的探讨永久性周围性面瘫(PPFP)对患者生活质量及焦虑抑郁症状的影响及其相关因素。方法选择扬州大学附属医院2017年1月至2018年1月治疗过的单侧PPFP患者79例(PPFP组)及健康体检者43例(对照组)为研究对象,以普适性量表-医学结局研究简表36项健康调查(SF-36)、中文版临床面部评价量表(FaCE)、Zung抑郁自评量表(SDS)及Zung焦虑自评量表(SAS)评分为工具,进行生活质量及抑郁状态的调查,分析PPFP患者生活质量及精神心理特征。结果SF-36调查显示,PPFP患者生命活力、社交功能、情感角色、心理健康4个维度的评分分别为(73.23±15.04)分、(72.41±15.46)分、(72.53±15.27)分、(73.35±14.54)分,均明显低于对照组的(97.56±3.76)分、(96.51±3.32)分、(97.09±2.49)分、(96.63±2.37)分(t=-10.506、-10.144、-10.505、-10.403,均P<0.001),但生理功能、生理职能、躯体疼痛、总体健康4个维度评分与对照组差异均无统计学意义(均P>0.05)。FaCE调查显示,PPFP患者总分为(48.63±17.44)分,明显低于对照组的(100.00±0.00)分(t=-19.281,P<0.05)。PPFP组SDS评分为(48.43±11.57)分,高于对照组的(40.63±5.39)分,差异有统计学意义(t=4.174,P<0.001)。两组焦虑症状评分差异无统计学意义(P>0.05)。相关性分析提示,FaCE与SF-36相关心理健康状况维度及SDS相关(r=-0.848~0.908,均P<0.001)。多元线性回归分析显示,婚姻状况(t=-2.442,P=0.017)、职业(t=-2.377,P=0.020)、年龄(t=-5.501,P=0.000)与PPFP患者抑郁症状评分呈负相关;有无联带运动(t=3.604,P=0.042)、House-Brackmann分级(HBGS)(t=2.116,P=0.038)、病程(t=4.152,P=0.000)与PPFP患者抑郁症状评分呈正相关。病程(t=-2.616,P=0.011)、HBGS(t=-6.523,P=0.000)与PPFP患者FaCE总评分呈负相关,有无联带运动(t=2.767,P=0.000)与PPFP患者FaCE总评分呈正相关。结论PPFP患者的生活质量较差并存在明显的心理健康问题。年龄、职业、婚姻状况、病程、HBGS程度、有无联带运动是导致PPFP患者抑郁情绪增高及生活质量降低的重要因素。
Objective To investigate the quality of life(QoL) and emotion symptoms(anxiety symptom and depressive symptom), and its influencing factors in patients with permanent peripheral facial paralysis(PPFP). Methods A case-control trial was conducted to evaluate the QoL status and emotion symptoms of 79 PPFP patients(PPFP group, disease course >12 months) between January 2017 and January 2018 from the Affiliated Hospital of Yangzhou University, and 42 healthy individuals were selected as control group.The generic questionnaire medical outcomes study short-form 36 items health survey(SF-36), Chinese version of facial clinimetric evaluation(FaCE) scale, self-rating depression scale(SDS) and self-rating anxiety scale(SAS) were evaluated.The correlation among SF-36, SDS, SAS and FaCE was evaluated.SPSS 21.0 software was used to analyze the data. Results By the assessment of SF-36, the score of vitality[(73.23±15.04)points], social function[(72.41±15.46)points], role-emotion[(72.53±15.27)points] and mental health[(73.35±14.54)points] in four dimensions of the PPFP group were lower than those of the control group [(97.56±3.76)points,(96.51±3.32)points,(97.09±2.49)points and (96.63±2.37)points](t=-10.506,-10.144,-10.505,-10.403, all P<0.001), but the scores of physical function, role-physica, bodily pain and general health in four domains of the PPFP group were similar with those of the control group (all P>0.05). By the assessment of FaCE, the total score of the PPFP group was lower than those of the control group [(48.63±17.44)points vs.(100.00±0.00)points, t=-19.281, P<0.05]. The score of SDS in the PPFP group was higher than those of the control group[(48.43±11.57)points vs.(40.63±5.39)points](t=4.174, P<0.001), but the score of SAS had no statistically significant difference between the two groups (P>0.05). According to the assessment of the correlation among SF-36, SDS, SAS and FaCE, the total scores of FaCE in the PPFP group was related only to SF-36 related mental health dimensions and SDS(r=-0.848~0.908, all P<0.001). Multiple linear regression analysis showed that marital status(t=-2.442, P=0.017), occupation(t=-2.377, P=0.020), and age(t=-5.501, P=0.000) were negatively correlated with the SDS scores;with/without synkinesis(t=3.604, P= 0.042), disease course(t=4.152, P=0.000), and the level of House-Brackmann grading system(HBGS)(t=2.116, P=0.038) were positively associated with the SDS of the PPFP group.However, disease course (t=-2.616, P=0.011), HBGS(t=-6.523, P=0.000) were negatively correlated with the total scores of FaCE, and with/without synkinesis(t= 2.767, P=0.000) was positively associated with the total scores of FaCE. Conclusion The patients with PFPP have a poorer quality of life and experienced greater psychological distress than healthy individuals.The present study suggested that age, gender, occupation, marital status, disease course, with/without synkinesis, the sources of PPFP and the level of HBGS are associated with depression increasing and quality of life decreasing in PPFP patients.
作者
余爵波
程泽星
庄远岭
Yu Juebo;Cheng Zexing;Zhuang Yuanling(Department of Otolaryngology,the Affiliated Hospital of Yangzhou University,Yangzhou,Jiangsu 225001,China)
出处
《中国基层医药》
CAS
2019年第19期2356-2361,共6页
Chinese Journal of Primary Medicine and Pharmacy
关键词
面神经麻痹
生活质量
抑郁
焦虑
心理生理性障碍
心理学
临床
问卷调查
临床面部评价量表
Facial Paralysis
Quality of life
Depression
Anxiety
Psychophysiologic disorders
Psychology,clinical
Questionnaires
Facial clinimetric evaluation
