听神经瘤患者围手术期抑郁与焦虑状况的调查  

Perioperative depression and anxiety in patients undergoing acoustic neuroma resection

作　　者：邹文辉[1] 廖声潮[1] 黄玮[1] 秦坤明[1] 杨雷霆[1] 冯大勤[1] 

机构地区：[1]广西医科大学第一附属医院神经外科,南宁530021

出　　处：《中华神经医学杂志》2012年第3期257-260,共4页Chinese Journal of Neuromedicine

基　　金：广西壮族自治区卫生厅自筹经费科研课题（Z2011332）

摘　　要：目的调查听神经瘤患者围手术期抑郁与焦虑的状况并分析其相关影响因素。方法选择自2010年6月至2011年6月在广西医科大学第一附属医院神经外科行开颅听神经瘤切除术的62例患者为研究对象，分别于术前1d、术后出院前1d应用Zung抑郁自评量表（SDS）和Zung焦虑自评量表（SAS）评估患者的抑郁及焦虑状况，面神经功能分级采用House-Brackmann分级法评定，自制表格记录相关因素。结果术前13例（20．9％）存在抑郁焦虑状态，术后24例（38．7％）存在抑郁焦虑状态。术前住院时间长、合并有慢性疾病、中青年患者术前容易出现抑郁焦虑。患者的性别、年龄、面神经功能H-B分级影响其术后抑郁焦虑的发生率。不同职业、文化程度、经济状况、是否有听力下降和平衡功能障碍的患者抑郁焦虑发生率差异无统计学意义（P＞0．05）。结论听神经瘤患者围手术期抑郁焦虑发生率高。女性、中青年、面神经功能障碍严重的患者可能为术后发生抑郁焦虑的高发病例，需要引起重视。Objective To investigate the prevalence of perioperative depression and anxiety in patients who underwent acoustic neuroma resection （ANR） and to analyze their associated factors. Methods This survey recruited 62 patients who accepted ANR from June 2010 through June 2011 in our department. Participants were interviewed one day preoperation and one day pre-discharge with 2 questionnaires： the Zung self-rating depression scale （SDS） and the Zung self-rating anxiety scale （SAS）. Personal information and clinical data were also documented. Facial nerve outcomes were reported according to the House-Brackmann scale. Statistical analysis was performed with the SPSS, version 13.0, using two-sample t-test, paired t-test, pearson Chi-square test and Binary classification unconditional logistic regression analysis. Significance was accepted at P〈0.05. Results Thirteen patients （20.9%） had depression and/or anxiety preoperation while 24 patients （38.7%） had postoperation. Patients with a long preoperative hospital stay, young in age （Wald=5.958, OR=0.910, P=0.015） and associated with chronic diseases （Wald=6.578, OR=14.591, P=-0.010） were prone to preoperative depression and/or anxiety. Female patients （Wald=4.258, OR = 4.572, P=-0.039）, young patients （Wald=8.152, OR=0.913, P=0.004） and patients with facial paralysis of H-B grade IV-VI （Wald=6.310, OR=7.630, P=-0.012） had a higher incidence of postoperative depression and/or anxiety. Occupation, educational level, economic status, hearing loss or balance dysfunction of the patients showed no statistically significant impact on the incidence of the condition. Conclusions Patients undergoing ANR tend to have a high incidence of perioperative depression and/or anxiety. Surgeons should pay special attention to and take effectivemeasures for female, young patients and those with facial dysfunction because they, in particular, are prone to postoperative depression and/or anxiety.

关 键 词：抑郁 焦虑 面瘫 听神经瘤 

分 类 号：R739.41[医药卫生—肿瘤]