肺癌患者术前不良情绪分析及对术后康复的影响研究  

Analysis of preoperative adverse emotion of patients with lung cancer and its effect on postoperative rehabilitation

作　　者：张瑞[1,2] 蒲强[1] 王烨[3] 梅小丽 刘伦旭[1] ZHANG Rui;PU Qiang;WANG Ye;MEI Xiaoli;LIU Lunxu(Department of Thoracic Surgery,West China Hospital,Sichuan University,Chengdu,610041,P.R.China;Department of Thoracic Surgery,Seventh People’s Hospital of Chengdu,Chengdu,610041,P.R.China;Mental Health Center,West China Hospital,Sichuan University,Chengdu,610041,P.R.China)

机构地区：[1]四川大学华西医院胸外科,成都610041 [2]成都市第七人民医院胸外科,成都610041 [3]四川大学华西医院心理卫生中心,成都610041

出　　处：《中国胸心血管外科临床杂志》2020年第7期775-779,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的研究肺癌患者术前不良情绪及其对术后康复的影响。方法回顾性分析2017年2月至2018年7月期间在四川大学华西医院胸外科行胸腔镜肺切除术1438例肺癌患者术前情绪状况及与围术期指标间的关系,其中男555例、女883例。所有患者均接受胸腔镜肺叶或肺段切除术加系统性淋巴结清扫或采样术,术前均进行了华西心晴指数评分,并依据评分分为无、轻度、中重度不良情绪3组,比较各组胸腔引流量、术后肺部感染率、术后引流时间、术后住院时间等。结果1438例肺癌患者中不良情绪发生率为9.8%,术前不良情绪发生与患者年龄、性别、受教育程度、吸烟差异有统计学意义(P<0.05)。单因素分析显示无、轻度、中重度不良情绪三组间,术后引流管留置天数、引流量、术后肺部感染率、术后其它并发症的发生率差异无统计学意义(P>0.05),但有不良情绪组的术后住院时间短于无不良情绪组,差异有统计学意义(P<0.05)。多元回归分析校正混杂因素后,上述结果在三组间的差异均无统计学意义(P>0.05)。结论年龄偏小的患者、女性、受教育程度高、不吸烟的患者更容易出现不良情绪。未见术前的不良情绪对肺癌患者接受胸腔镜微创手术治疗后快速康复产生不良影响。Objective To examine the effect of preoperative adverse emotion on rehabilitation outcomes in lung cancer patients undergoing thoracoscopic major pulmonary resection.Methods We retrospectively analyzed the clinical data of 1438 patients with lung cancer who underwent thoracoscopic lobectomy and segmentectomy in West China Hospital of Sichuan University from February 2017 to July 2018 including 555 males and 883 females.All patients were assessed by Huaxi emotional-distress index scoring,and were divided into three groups including a non-negative emotion group,a mild negative emotion group,and a moderate-severe negative emotion group.All patients underwent thoracoscopic lobectomy or segmentectomy plus systematic lymph node dissection or sampling.The volume of postoperative chest drainage,postoperative lung infection rate,time of chest tube intubation and postoperative duration of hospitalization were compared among these three groups.Results There were different morbidities of adverse emotion in age,sex,education level and smoking among patients before operation(P<0.05).Univariate analysis showed that there was no statistical difference in the duration of indwelling drainage tube,drainage volume,postoperative pulmonary infection rate or the incidence of other complications among these three groups,but the duration of hospitalization in the latter two groups was less than that in the first group with a statistical difference(P<0.05).After correction of confounding factors by multiple regression analysis,there was no statistical difference among the three groups.Conclusion Young patients are more likely to develop bad emotions,women are more likely to develop serious bad emotions,highly educated patients tend to develop bad emotions,and non-smoking patients tend to develop bad emotions.There is no effect of preoperative adverse emotions on the rapid recovery of lung cancer patients after minimally invasive thoracoscopic surgery.

关 键 词：快速康复 肺癌 不良情绪 心晴指数 治疗 

分 类 号：R734.2[医药卫生—肿瘤]