手术切除与PMCT治疗原发性小肝癌患者焦虑、抑郁状况的对比分析  

The Contrast Analysis on Anxiety and Depression Condition of Small Primary Liver Cancer Patients under Surgical Resection/PMCT Treatment

作　　者：石玉柱[1] 连斌[2] 吴宏 唐云翔[4] 孙亚林[2] 盛月红[2] 许苹[1] 

机构地区：[1]第二军医大学卫生勤务学系,上海200433 [2]第二军医大学附属东方肝胆外科医院,上海200433 [3]上海市卫生和计划生育委员会医政处,上海200125 [4]第二军医大学心理与精神卫生学系,上海200433

出　　处：《成都医学院学报》2016年第1期35-39,44,共6页Journal of Chengdu Medical College

基　　金：上海市卫生和计划生育委员会科研课题(No:20124010)

摘　　要：目的对比分析手术切除与微波引导下经皮穿刺微波凝固治疗(percutaneous puncture of microwave coagulation therapy,PMCT)治疗原发性小肝癌(直径≤5cm)患者的焦虑和抑郁状况。方法将250例原发性小肝癌患者按照治疗方法的不同分成手术切除组(n=126)和PMCT组(n=124),应用医院焦虑抑郁量表(hospital anxiety and depression scale,HADS)对两组患者术前确诊时、术后2周、术后1月、3月、6月和9月的焦虑和抑郁状况进行对比分析。结果两组患者均表现有焦虑和抑郁症状,但PMCT组各时点焦虑和抑郁症状发生率均低于手术切除组;两组患者术前确诊时抑郁症状评分比较,差异无统计学意义(P>0.05);其余时点两种情绪症状比较,差异均有统计学意义(P<0.05);PMCT组患者焦虑和抑郁症状发生率随时间的延长逐渐降低,且与术前确诊时评分比较,差异均有统计学意义(P<0.05);手术切除组患者各时点焦虑症状发生率随时间的延长逐渐降低,抑郁发生率则先升后降,术后1月的抑郁评分与术前确诊时比较,差异无统计学意义(P>0.05),其他时点两种情绪症状评分与术前确诊时比较,差异均有统计学意义(P<0.05)。结论两组患者均发生了焦虑和抑郁等情绪障碍,但PMCT组患者焦虑、抑郁症状的发生率较手术切除组低,术后情绪障碍恢复也较手术切除组快,加强临床心理干预性治疗有助于缓解患者情绪障碍,提高生命质量。Objective Compare and analyze the small primary liver cancer（diameter≤5cm）patients′anxiety and depression condition under surgical resection or PMCT treatment.Methods 250 primary liver cancer（diameter≤5cm）patients was divided into surgical resection group（n=126）and PMCT group（n=124）according to different treatment methods.Hospital Anxiety and Depression Scale（HADS）was used to compare and analyze both groups′anxiety and depression condition at diagnosis,2weeks,1months,3months,6months,9months after operation.Results Both groups showed anxiety and depression and the incidence of patients′anxiety and depression in PMCT group was lower than that of surgical resection group;there was no statistically significant difference between the two groups in terms of depression scores at diagnosis（P〉0.05）;there were statistically significant differences between the two groups in terms of depression and anxiety at other postoperative time（P〈0.05）.In PMCT group,patients′anxiety and depression incidence was gradually reduced with the extension of time,and compared with preoperative level,there were statistically significant differences（P〈0.05）.In surgical resection group,patients′anxiety incidence was also gradually reduce with the extension of time,but the depression incidence showed a trend of rise first then fall,the difference of each postoperative time was statistical significance（P〉0.05）compared with the preoperative level except the depression at 1 months postoperative（P〈0.05）.Conclusion Both groups had anxiety and depression,but the patients′anxiety and depression incidence and recovery time-use in PMCT group were lower than those of the surgery group.Strengthening clinical psychological intervention was helpful to mood disorders and improve quality of live in patients.

关 键 词：原发性小肝癌 开腹切除 PMCT 焦虑 抑郁 

分 类 号：R735.7[医药卫生—肿瘤]