【摘要】 目的探讨喉癌患者术后抑郁、焦虑发病的因素及其对喉癌患者预后和生活质量的影响。方法对2010年1月1日~2012年10月31日在我院住院的84例喉癌患者于术后1个月进行问卷调查,包括一般资料问卷、Zung焦虑自评量表和抑郁自评量表,而生活质量EORTC QLQ-C30问卷分别在术后1个月、3年和5年进行问卷调查。应用SPSS 19.0统计学软件完成数据统计及分析。结果 78例喉癌患者完成随访,3年生存率为71.79%(56/78),5年生存率为57.69%(45/78)。术后1个月有52例(66.67%)患者抑郁阳性,43例(55.13%)患者焦虑阳性。低文化水平、低收入、长期吸烟、喉全切除及术后放疗的喉癌患者抑郁的发病率高,而经常吸烟、喉全切除、发音功能及吞咽功能差的喉癌术后患者,焦虑的发病率高。抑郁组与对照组相比,术后5年的生存率差异有统计学意义,而术后3年生存率的差异无统计学意义;焦虑组和对照组相比,术后3年、5年生存率差异均无统计学意义。术后抑郁对患者的整体健康状况影响较大,但焦虑对生活质量的影响范围更广。抑郁和焦虑对患者术后失眠均有较大影响,且贯穿整个观察时间。结论多重因素导致喉癌患者术后抑郁和焦虑。仅抑郁对患者术后5年生存率有影响;抑郁和焦虑均对患者术后生活质量造成影响,但影响方面不同。更多还原

【Abstract】 OBJECTIVE To invest igate the etiological factors of depression and anxiety in postoperative patients with laryngeal cancer and study the effects on prognosis and quality of life(QOL). METHODS Laryngeal cancer patients treated with different surgery,were asked to participate in the study using the general data questionnaire, Self-rating depression scale(SDS) and Self-rating anxiety scale(SAS) one month after operation.QOL was investigated with EORTC QLQ-C30(European organization for Treatment of Cancer Core-30 Questionnaire Scores, Version 3.0) on 3 time points: 1 month, 3 year and5 year after operation. RESULTS Fifty-two(66.67%)patients were considered to be depression, and 43(55.13%)were considered to be anxiety. Low education level, low personal income level, total laryngectomy, long-term smoking and radiotherapy increased the incidence of depression, and long-term smoking, total laryngectomy, poor phonation and swallowing function increased the incidence of anxiety. Compared with the control group, the 5 year survival rate was decreased in depression group, but 3 year survival rate with no difference statistically. There was no significant difference in the 3 and 5 year survival rates between the anxiety group and the control group. Depression had a greater impact on the overall health of the patients, but anxiety had a wider impact on the quality of life. Depression and anxiety had great influence on the patients’ insomnia after operation and through the whole observation time. CONCLUSION Multiple factors lead to depression and anxiety in postoperative patients with laryngeal cancer. Only depression has an effect on the 5 year survival rate of patients. Both depression and anxiety affect the quality of life of the patients, but their influence is different.更多还原