口腔颌面部恶性肿瘤PEG围手术期患者心理状况调查  

Investigation of psychological status of patients with oral and maxillofacial malignant tumors during PEG

作　　者：陆如平 高慧[1] 吴嘉骏[2] 盛嘉玲 徐兵[2] 顾燕[1] 沈怡[1] 戴晶璟 LU Ruping;GAO Hui;WU Jiajun;SHENG Jialing;XU Bing;SHEN Yi;DAI Jingjing(Shanghai No.1 Civil Mental Health Center,Shanghai 201105,China;Shanghai Ninth People＇s Hospital,Shanghai JiaoTong University School of Medicine)

机构地区：[1]上海市民政第一精神卫生中心,上海201105 [2]上海交通大学医学院附属第九人民医院

出　　处：《中国民康医学》2018年第21期86-89,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:通过对口腔颌面部恶性肿瘤PEG围手术期受试者的心理量表测定,分析受试者心理状况特点。方法:选取接受经皮胃镜下胃造瘘术(PEG)的176例口腔颌面部恶性肿瘤患者为研究对象,分别在接受PEG前后进行"症状自评量表(SCL-90)""汉密顿抑郁量表(HAMD)""汉密顿焦虑量表(HAMA)""医学应对问卷(MCMQ)""总体幸福感量表(GWB)"等5项量表的评定,以评估其心理状况。结果:PEG 8周时SCL-90总分及各项因子分值均较PEG前减少(P<0.01),PEG前后评定总分均较健康人常模高(P<0.01);HAMD及HAMA评定显示,PEG 8周时评分均较PEG前低(P<0.01),且仍有40.34%的患者存在抑郁症状、48.30%存在焦虑症状;PEG前对患者进行的MCMQ评定结果与沈晓红等[14]对各类慢性病患者的测试结果相比差异无统计学意义(P>0.05);GWB评定显示男性总体幸福感高于女性(P<0.01),接受PEG 8周后评分高于PEG前(P<0.01)。结论:拟接受PEG的口腔颌面部恶性肿瘤患者普遍存在抑郁、焦虑等症状,对自身疾病选择"屈服"等消极应对策略,总体幸福感低;接受PEG后患者的抑郁、焦虑等症状得到一定改善,但仍低于健康人水平。Objective： To analyze psychological characteristics of subjects with oral and maxillofacial malignant tumors during the perioperative period of PEG by psychological scale. Methods： 176 patients undergoing percutaneous endoscopic gastrostomy（PEG） were selected as the survey subjects. They were evaluated by the symptom checklist 90（SCL-90） Hamilton depression scale（HAMD） Hamilton anxiety scale（HAMA） medical coping modes questionnaire（MCMQ） and general well-being schedule（GWB） to assess the psychological statuses before and after PEG. Results： 8 weeks after PEG, the total score and factor scores of SCL-90 were lower than those before PEG（P〈0.01） and the total scores before or after PEG were both higher than the norm（P〈0.01）. The HAMD and HAMA scores 8 weeks after PEG were lower than those before PEG（P〈0.01）, but there were still 40.34% of the patients with depression symptoms and 48.30% with anxiety symptoms. There were no statistical differences in the MCMQ scores between the present study and that of Shen Xiaohong et al before PEG（P〉0.05）. GWB assessment showed that general well-being feel of the male patients was stronger than that of the female patients（P〈0.01）, and the GWB score 8 weeks after PEG was higher than that before PEG（P〈0.01）. Conclusions： The depression and anxiety symptoms generally exist in the oral and maxillofacial malignant tumor patients planning to undergo PEG, and they take negative strategies towards their disease such as ＂yielding to＂ with an overall low well-being. However, after PEG, the depression and anxiety symptoms of these patients are improved but still lower than the normal level.

关 键 词：经皮胃镜下胃造瘘术 口腔颌面部恶性肿瘤 心理状况 

分 类 号：R739.81[医药卫生—肿瘤]