一项癌痛患者焦虑抑郁的回顾性队列研究  

A RETROSPECTIVE COHORT STUDY OF DEPRESSION AND ANXIETY OF CANCER PAIN PATIENTS

作　　者：李小梅 肖文华[2] 焦顺昌[3] 杨平[4] 朱建华[2] 李方[3] 赵慧霞[2] 刘端祺[5] 

机构地区：[1]解放军总医院南楼肿瘤内科,北京100853 [2]解放军总医院第一附属医院肿瘤科,北京100048 [3]解放军总医院肿瘤内科,北京100853 [4]海军总医院肿瘤科,北京100048 [5]北京军区总医院专家组,北京100700

出　　处：《中国疼痛医学杂志》2016年第5期354-359,共6页Chinese Journal of Pain Medicine

摘　　要：目的:调查癌痛患者的整体疼痛控制情况,评估并比较疼痛和无痛肿瘤患者的焦虑抑郁及影响因素。方法:为回顾性研究,恶性肿瘤患者按有无疼痛分两组行问卷调查。用BPI-C量表、状态-特质焦虑问卷(state-trait anxiety inventory,STAI)评估状态性焦虑(state anxiety,SA)和特质性焦虑(trait anxiety,TA)、Beck抑郁问卷(beck depression inventory,BDI-II)评估疼痛、焦虑及抑郁,用逐步回归法分析两组患者焦虑和抑郁的影响因素。结果:共收集有效问卷121份(疼痛组62份、非癌痛59份)。两组患者基线资料无显著差异(P>0.05)。疼痛组的最重和平均疼痛强度分别为7.46(2.19)、5.71(2.23),疼痛对日常活动、睡眠和日常工作都有中度以上的影响。疼痛组各级抑郁人数、SA均值均显著高于无痛组,但TA均值无显著差异。疼痛组的BDI得分与最重疼痛程度和癌痛持续时间正相关,与疼痛缓解度负相关(R=0.81,F=17.80,P<0.001);SA得分则与最重疼痛程度和肿瘤分期正相关(R=0.54,F=20.67,P<0.001);未发现与疼痛患者TA得分相关的因素,也未发现任何变量与无痛患者的BDI、SA和TA得分相关。结论:癌痛控制不足仍普遍存在,显著影响患者的生活质量,也是导致患者焦虑和抑郁的主因。应动态评估癌痛并及时调整治疗,给予必要的心理支持。Objecitve： To investigate the overall cancer pain control; to evaluate and compare anxiety and depression in cancer patients with or without pain and to analyze factors associated with anxiety and depression. Methods： This is a retrospective study. Stratified by pain status, cancer patients rated pain, anxiety and depression on the Chinese version of brief pain inventory（BPI）, state-trait anxiety inventory（STAI） and beck depression inventory（BDI-II）. Multivariate stepwise regression analysis were used to analysis the factors associated with anxiety and depression of the two groups separately. Results： 121 cancer patients（pain group=62, no-pain group=59） were evaluated. The baseline data was without significant difference. Of the pain group, the worst and average pain intensity（PI） were 7.46（2.19） and 5.71（2.23）respectively. Patients＇ daily activity, sleep and daily work were moderately interfered. The number of patients with depression and the mean SA score in the pain group were significantly higher than the no-pain group, but TA score had no significant difference. The worst PI and length of cancer pain were positive predictors of depression and the extent of pain relief was negative predictors.（R = 0.81,F = 17.80,P〈0.001）. The worst PI and the stage of cancer were predictors of SA（R = 0.54, F = 20.67, P〈0.001）. No factors associated with pain patient＇ s TA score. Additionally, no variables were found to be associated with BDI, SA and TA score of the no-pain group. Conclusions： Under treatment of cancer pain were still prevalent and patient＇ s QOL were significantly interfered. Pain is also a main factor associated with patients＇ anxiety and depression. Cancer pain should be evaluated dynamically and pain treatment should be adjusted timely. Necessary psychological support and interventions should also be confirmed.

关 键 词：癌性疼痛 焦虑 抑郁 问卷调查 

分 类 号：R730.5[医药卫生—肿瘤]