乳腺癌保乳术后患者负性心理及相关影响因素分析  

Analysis of negative psychology and related factors in patients with breast cancer after breast-conserving surgery

作　　者：梁晓丹 梁冰[1] 张强[1] 柴丽君[1] Liang Xiaodan;Liang Bing;Zhang Qiang;Chai Lijun(Department of Breast Surgery,The Second Affiliate Hospital of Zhengzhou University,Zhengzhou 450014,China)

机构地区：[1]郑州大学第二附属医院乳腺外科,郑州450014

出　　处：《河南外科学杂志》2024年第4期15-19,共5页Henan Journal of Surgery

摘　　要：目的分析乳腺癌保乳术后患者的负性心理及相关影响因素。方法回顾性分析2020-01—2022-12郑州大学第二附属医院乳腺外科行保乳手术后的180例乳腺癌患者的临床资料。采取现场问卷调查的方法,嘱患者完成焦虑自评量表(SAS)以及抑郁自评量表(SDS)的填写并评价患者的负性心理。采用单因素分析和多因素Logistic分析研究术后患者的负性心理及相关影响因素。结果180例患者的SAS平均评分为(46.51±14.03)分,SDS平均评分为(48.77±12.16)分。以≥50分为存在负性心理,将患者分为存在负性心理组和不存在负性心理组。单因素分析结果显示,2组患者年龄、居住地、文化程度、家庭收入水平、医疗费用支付方式、肿瘤TNM分期、术后放化疗方式的差异均有统计学意义(P<0.05)。Logistic回归分析结果显示,年龄较小(OR=0.979)、家庭人均月收入低于2000元(OR=4.893)、医疗费用支付方式为自费(OR=4.898)、肿瘤分期为Ⅱ期(OR=5.403)、术后接受化疗(OR=3.672)、术后接受放疗(OR=3.567)是乳腺癌保乳手术后患者负性心理的独立影响因素。利用Logistic回归模型的独立影响因素以及P值预测概率对乳腺癌保乳手术后患者负性心理出现的发生情况进行ROC曲线的预测,约登指数分别为21.32%、0.52%、20.65%、21.54%、20.13%、17.95%、40.08%。结论乳腺癌保乳手术后患者发生负性心理的风险较高,年龄较小、家庭收入较低、自费、肿瘤分期为Ⅱ期,以及术后行化、放疗是患者发生负性心理的独立影响因素。Objective To investigate the negative psychology and related influencing factors of breast cancer patients after breast-conserving surgery.Methods To analyze retrospectively the clinical data of 180 patients who had breast cancer,and they all had breast conservation surgery in the Department of Breast Surgery of the Second Affiliated Hospital of Zhengzhou University from Jan.2020 to Dec.2022.By using an on-site questionnaire survey method,patients were asked to complete the Anxiety Self-Rating Scale(SAS)and the Depression Self-Rating Scale(SDS),then evaluated the negative psychology of the patients.Univariate analysis and multivariate Logistic analysis were used to study the negative psychology and related influencing factors of postoperative patients.Results The average SAS score and SDS score of 180 patients were(46.51±14.03)and(48.77±12.16).Divided patients into a group with negative psychology and a group without negative psychology based on a score of≥50.The results of univariate analysis showed that there were statistically significant differences in age,place of residence,education level,family income level,the method of medical payment,TNM staging of tumor,and postoperative radiotherapy and chemotherapy methods between the two groups of patients(P<0.05).The results of Logistic regression analysis showed that young age(OR=0.979),family income less than 2000 yuan/person/month(OR=4.893),self-payment of medical expenses(OR=4.898),stageⅡ(OR=5.403),postoperative chemotherapy(OR=3.672),and postoperative radiotherapy(OR=3.567)were independent influencing factors of negative psychology in patients with breast cancer after breast-conserving surgery.Using the independent influencing factors of Logistic regression model and the predictive probability of P value,the ROC curve was drawn for the occurrence of negative psychology in patients after breast conserving surgery,and the Youden index was 21.32%,0.52%,20.65%,21.54%,20.13%,17.95%and 40.08%.Conclusion The risk of negative psychology in patients with breast c

关 键 词：乳腺癌 保乳手术 负性心理 

分 类 号：R737.9[医药卫生—肿瘤]