乳腺癌患者腋窝淋巴结清扫术后心理问题的危险因素分析  

Risk Factors for Psychological Problems After Axillary Lymph Node Dissection for Breast Cancer

作　　者：何宝清 李翠华 李佳钱 汤宗文 陈琴 He Baoqing;Li Cuihua;Li Jiaqian(Ningdu Cuiwei Hospital,Ningdu,Jiangxi,342800,China)

机构地区：[1]江西省宁都翠微医院,江西宁都342800 [2]江西省宁都县人民医院,江西宁都342800

出　　处：《黑龙江医学》2025年第8期906-909,共4页Heilongjiang Medical Journal

摘　　要：目的:探讨乳腺癌患者腋窝淋巴结清扫术后3个月影响患者术后心理状况的相关因素。方法:选取2013年11月—2016年12月于样本医院接受腋窝淋巴结清扫的237例连续术后乳腺癌患者作为研究对象。排除难以评估心理状况的37例患者,余下的200例患者使用心理痛苦温度计量表(DIT)将患有适应障碍、抑郁症或重度抑郁症和自杀意念的74例患者分作有心理问题(GWPP)组,其余126例患者作为无心理问题(GWNPP)组。结果:两组患者手术前后精神障碍发病率比较,差异无统计学意义(χ^(2)=5.62,P>0.05);两组患者单因素分析结果显示,上肢功能(DASH)、术后化疗和术后激素治疗比较,差异均有统计学意义(t=7.66,χ^(2)=5.51、5.54;P<0.05);logistic回归分析结果表明,DASH是影响心理状况的重要因素(OR=1.114);通过受试者操作特征曲线分析,DASH评分≥18分对于预测心理状况具有高特异性。结论:乳腺癌患者腋窝淋巴结清扫术后躯体症状和上肢功能丧失与心理状态有关,提示术后康复的重要性。Objective:To explore the related factors affecting the postoperative psychological status of patients with breast cancer after 3 months of axillary lymph node dissection.Methods:A total of 237 consecutive postoperative breast cancer patients who underwent axillary lymph node dissection in sample hospitals from November 2013 to December 2016 were selected as the study objects.37 patients whose psychological status is difficult to access were excluded,and 200 patients used DIT.74 patients with adjustment disorder,depression or major depression,and suicidal ideation were divided into a group with psychological problems and the rest into a group without psychological problems using the psychological pain thermometer scale.Results:There was no significant difference in the incidence of mental disorders before and after operation(χ^(2)=5.62,P>0.05).Univariate analysis showed that DASH,postoperative chemotherapy and postoperative hormone therapy were significantly different between the two groups(t=7.66;χ^(2)=5.51,5.54;P<0.05).Logistic regression analysis showed that DASH was an important factor affecting psychological status(OR=1.114).A DASH score of 18 or higher was highly specific for predicting psychological status,as measured by subject operating characteristic curve analysis.Conclusion:Physical symptoms and loss of upper limb function after axillary lymph node dissection for breast cancer are related to psychological state,suggesting the importance of postoperative rehabilitation.

关 键 词：乳腺癌 上肢功能 康复 心理状况 化疗 

分 类 号：R737.9[医药卫生—肿瘤]