癌症患者化疗前焦虑对化疗后恶心呕吐的影响  

A Clinical Study on the Effects of Prechemotherapy Anxiety on Post-chemotherapy Nausea and Vomiting in Cancer Patients

作　　者：周灵 左瑞玲 马莉[1] 杨艳阳 胡雪姣 谢琳[1] ZHOU Ling;ZUO Rui-ling;MA Li;YANG Yan-yang;HU Xue-jiao;XIE Lin(Dept.of Gastrointestinal Oncology,The 3rd Affiliated Hospital of Kunming Medical University,Tumor Hospital of Yunnan Province,Kunming Yunnan 650118;Dept.of Emergency Medicine,The 4th Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650021;Dept.of Hematology,The 3rd Affiliated Hospital of Kunming Medical University,Tumor Hospital of Yunnan Province,Kunming Yunnan 650118,China)

机构地区：[1]昆明医科大学第三附属医院/云南省肿瘤医院消化肿瘤内科,云南昆明650118 [2]昆明医科大学第四附属医院急诊医学科,云南昆明650021 [3]昆明医科大学第三附属医院/云南省肿瘤医院血液科,云南昆明650118

出　　处：《昆明医科大学学报》2020年第4期142-149,共8页Journal of Kunming Medical University

基　　金：昆明医科大学大学生创新性试验计划基金资助项目(2017NO.3);昆明医科大学硕士研究生创新基金资助项目(2019S189)。

摘　　要：目的探究肿瘤患者化疗前焦虑与化疗后恶心呕吐的相关性以及影响化疗前焦虑及化疗后恶心呕吐的相关因素。方法对94例使用高致吐化疗方案的恶性肿瘤患者进行相关资料调查,包括检验学资料、NCI-CTC V4.0、SAS评分情况等,使用SPSS统计软件进行Spearman相关分析,多因素分析采用Logistic回归。结果化疗前无焦虑患者SAS与恶心程度呈弱正相关;化疗前轻度焦虑患者SAS与恶心、呕吐程度均成低度正相关;化疗前中度焦虑患者SAS与恶心、呕吐程度均成中度正相关相关;化疗前重度焦虑患者SAS与恶心程度成中度正相关,差异有统计学意义(P <0.05);多因素分析结果提示低白蛋白(OR=3.702, 95%CI:1.406-9.746;P=0.008)、低钠(OR=4.604, 95%CI:1.349-15.710;P=0.014)是化疗前1 d焦虑的独立危险因素(P <0.05);高尿酸(OR=5.006, 95%CI:1.684-14.882;P=0.003)、低糖(OR=2.727, 95%CI:6.879-1.840;P=0.004)是化疗后一天恶心的独立危险因素,P<0.05;高钙(OR=6.138, 95%CI:1.803-10.899;P=0.003)是化疗后一天呕吐的独立危险因素(P <0.05)。结论化疗前的焦虑情绪与化疗后恶心、呕吐程度密切相关,应积极进行化疗前筛查及评估,从心理及生理各方面对可能发生焦虑的患者进行干预,缓解化疗前焦虑程度,以减轻化疗期间副作用的发生。Objective To explore the correlation between prechemotherapy anxiety and nausea and vomiting after chemotherapy in cancer patients and the related factors affecting the prechemotherapy anxiety and nausea and vomiting after chemotherapy. Me thods Relevant data of 94 patients with malignant tumors treated with emetogenic chemotherapy were analyzed, including laboratory data, NCI-CTC V4.0, and SAS score. Spearman correlation analysis was conducted with SPSS,and Logistic regression was used for multivariate analysis.Re s ults There was a weak positive correlation between SAS and nausea in patients without anxiety before chemotherapy. There was a low positive correlation between SAS and nausea and vomiting in patients with mild anxiety before chemotherapy. There was a moderate positive correlation between SAS and nausea and vomiting in patients with moderate anxiety before chemotherapy. There was a moderate positive correlation between SAS and nausea in patients with severe anxiety before chemotherapy, all of which were P < 0.05, showing statistically significant difference. Multivariate analysis showed low protein(OR=3.702, 95% CI: 1.406-9.746;P =0.008) and low sodium(OR=4.604, 95% CI:1.349-15.710;P =0.014) were independent risk factors for anxiety one day before chemotherapy(P < 0.05).Highuric acid and(OR=5.006, 95% CI: 1.684-14.882;P =0.003) and hypoglycemia(OR=2.727,95% CI:6.879-1.840;P = 0.004) were independent risk factors for nausea on the day after chemotherapy(P < 0.05).High calcium(OR=6.138, 95% CI: 1.803-10.899;P = 0.003) was an independent risk factor for vomiting on the day after chemotherapy( P < 0.05). Conclus ion Prechemotherapy of anxiety is related to the nausea and vomiting after chemotherapy, soactively screening and evaluation before chemotherapy is important. Psychological and physical intervention on the anxiety of the patients to alleviate anxiety before chemotherapy can alleviate the side effects of chemotherapy.

关 键 词：癌症 化疗 焦虑 恶心 呕吐 

分 类 号：R730[医药卫生—肿瘤]