肺癌患者手术前后睡眠障碍的影响因素分析  

Analysis of influencing factors of sleep disturbance in patients with lung cancer before and after surgery

作　　者：徐娜[1] 秦芹[1] 廖佳[1] 王雅琴[1] 魏星 戴维[1] 谢天鹏[1] 李强[1] 刘晓琴[1] XU Na;QIN Qin;LIAO Jia;WANG Ya-qin;WEI Xing;DAI Wei;XIE Tian-peng;LI Qiang;LIU Xiao-qin(Department of Thoracic Surgery,Sichuan Cancer Hospital,Chengdu,Sichuan 610041,China)

机构地区：[1]四川省肿瘤医院胸外科,四川成都610041

出　　处：《临床肺科杂志》2023年第3期336-339,352,共5页Journal of Clinical Pulmonary Medicine

摘　　要：目的 调查肺癌手术患者住院期间睡眠障碍的影响因素。方法 选取2017年11月-2020年1月6家三级医院421例肺癌手术患者,采用MD安德森症状评估量表-肺癌子表收集患者睡眠障碍的评分情况。将≥4分定义为有睡眠障碍。采用Logistic回归确定患者术前和术后住院期间每日睡眠障碍的影响因素。结果 肺癌患者术前睡眠障碍发生率为22.5%;术后第1天最严重,为50.4%;术后第2天~7天发生率为30.7%~37.1%。多因素分析显示:肺癌患者术前睡眠障碍的影响因素是苦恼和口干,术后第1天是术前新辅助治疗、胸管根数、手术入路、疼痛、疲劳和气短,术后第2天是疼痛、疲劳、气短和瞌睡,术后第3天是疲劳和咳嗽,术后第4天是病理分期、疼痛、疲劳和咳嗽,术后第5天是疼痛、疲劳和咳嗽,术后第6天是查尔森合并症指数评分、疼痛、疲劳和咳嗽,术后第7天是疼痛、疲劳和气短(P<0.05)。结论 肺癌患者手术前后睡眠障碍发生率高,应重视患者的术前心理干预和术后症状控制,以改善其睡眠质量。Objective To investigate the influencing factors of sleep disturbance in patients undergoing lung cancer surgery during hospitalization. Methods A total of 421 patients undergoing lung cancer surgery in 6 tertiary hospitals from November 2017 to January 2020 were selected. Sleep disturbance scores were assessed using the MD Anderson Symptom Inventory-Lung Cancer module. A score of ≥4 was defined as having sleep disturbance. Logistic regression was used to determine the influencing factors of sleep disturbance during preoperative and postoperative hospitalization.Results The incidence of preoperative sleep disturbance in lung cancer patients was 22.5%.Patients had the most severe sleep disturbance on postoperative day(POD) 1, with an incidence of 50.4%. The incidenceswere 30.7%~37.1% on POD 2 to POD 7. Multivariate analysis showed that the influencing factors of sleep disturbance in lung cancer patients were distress and dry mouth preoperatively;preoperative neoadjuvant therapy, chest tube number, surgical approach, pain, fatigue, and shortness of breath on POD 1;pain, fatigue, shortness of breath and drowsiness on POD 2;fatigue and coughing on POD 3;pathological stage, pain, fatigue and coughing on POD 4;pain, fatigue and coughing on POD 5;Charlson Comorbidity Index score, pain, fatigue and coughing on POD 6;and pain, fatigue and shortness of breath on POD 7(all P<0.05).Conclusion Patients undergoing lung cancer surgery have a high incidence of sleep disturbance before and after surgery. In clinical practice, patients? preoperative psychological interventions and postoperative symptom control need to be given attention to improve their sleep quality.

关 键 词：肺癌 手术治疗 睡眠障碍 影响因素 疼痛 

分 类 号：R734.2[医药卫生—肿瘤] R740[医药卫生—临床医学]