| 胡根花,张 倩,严丽洁,郭阳阳,孔 媛.乳腺癌根治术患者术前焦虑的影响因素分析及其对术后恢复、细胞免疫功能和生命质量的影响[J].,2023,(17):3263-3267 |
| 乳腺癌根治术患者术前焦虑的影响因素分析及其对术后恢复、细胞免疫功能和生命质量的影响 |
| Analysis of Influencing Factors of Preoperative Anxiety in Patients Undergoing Radical Mastectomy and its Effect on Postoperative Recovery, Cellular Immune Function and Quality of Life |
| 投稿时间：2023-03-05 修订日期：2023-04-02 |
| DOI：10.13241/j.cnki.pmb.2023.17.012 |
| 中文关键词: 乳腺癌根治术 术前焦虑 影响因素 术后恢复 细胞免疫 生命质量 |
| 英文关键词: Radical mastectomy Preoperative anxiety Influencing factors Postoperative recovery Cellular immune Quality of life |
| 基金项目:江苏省卫健委妇幼健康科研面上项目（F201846） |
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| 中文摘要: |
| 摘要 目的：分析乳腺癌根治术患者术前焦虑的影响因素，并探讨术前焦虑对患者术后恢复、细胞免疫功能和生命质量的影响。方法：选择我院2020年3月~2021年12月期间收治的拟行乳腺癌根治术的120例患者作为研究对象，术前1 d采用焦虑自评量表（SAS）评估所有患者的焦虑状况，根据是否存在焦虑分为焦虑组和无焦虑组，乳腺癌根治术患者术前焦虑的影响因素采用多因素Logistic回归分析。对比焦虑组和无焦虑组的术后恢复、细胞免疫功能和生命质量情况。结果：120例乳腺癌根治术患者中，有31例患者无术前焦虑，89例患者存在焦虑症状，根据是否存在术前焦虑分为焦虑组（n=89）和无焦虑组（n=31）。乳腺癌根治术患者术前焦虑与年龄、文化程度、家庭人均月收入、付费方式、婚姻状况、家庭支持、既往有无全麻史、术前住院时长、定期体检有关（P<0.05）。多因素Logistic回归分析结果表明：年龄＜60岁、文化程度为小学及其以下、家庭人均月收入＜3000元、婚姻状况为未婚、无家庭支持、既往无全麻史、术前住院时长>1 d是乳腺癌根治术患者术前焦虑的危险因素（P<0.05）。焦虑组的术后首次肛门排气时间、首次下床活动时间、术后住院时间均长于无焦虑组（P<0.05）。两组术后1个月CD3+、CD4+、CD4+/CD8+水平升高，且无焦虑组高于焦虑组（P<0.05），两组术后1个月CD8+水平下降，且无焦虑组低于焦虑组（P<0.05）。两组术后1个月生理状况、情感状况、社会/家庭状况、功能状况、附加关注评分和总分下降，且无焦虑组低于焦虑组（P<0.05）。结论：乳腺癌根治术患者术前焦虑发生率较高，其发生受到年龄、文化程度、家庭人均月收入、婚姻状况、家庭支持、既往有无全麻史、术前住院时长等多种因素的影响，可导致患者术后恢复时间延长，细胞免疫功能和生命质量降低。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the influencing factors of preoperative anxiety in patients undergoing radical mastectomy, and to explore the effects of preoperative anxiety on postoperative recovery, cellular immune function and quality of life. Methods: 120 patients who planned to undergo radical mastectomy in our hospital from March 2020 to December 2021 were selected as research objects. Anxiety status of all patients was assessed by self-rating anxiety Scale (SAS) at 1d before surgery, and they were divided into anxious group and non-anxious group according to whether there was preoperative anxiety. The influencing factors of preoperative anxiety in patients undergoing radical mastectomy were analyzed by multivariate Logistic regression. Postoperative recovery, cellular immune function and quality of life were compared between the anxious group and non-anxious group. Results: Among 120 patients undergoing radical mastectomy, 31 patients had no preoperative anxiety, and 89 patients had anxiety symptoms. They were divided into the anxious group (n=89) and the non-anxious group (n=31) according to whether there was preoperative anxiety. The preoperative anxiety of patients with radical mastectomy were correlated with age, education level, family per capita monthly income, payment method, marital status, family support, previous history of general anesthesia, length of hospital stay before operation and regular physical examination (P<0.05). Multivariate Logistic regression analysis showed that age < 60 years, education level of primary school or below, family per capita monthly income < 3000 yuan, marital status unmarried, no family support, no previous history of general anesthesia, length of hospital stay before operation >1 d were risk factors for preoperative anxiety in patients with radical mastectomy(P<0.05). The postoperative first anal exhaust time, the first time to get out of bed and the postoperative length of hospital stay in the anxious group were all longer than those in the non-anxious group(P<0.05). The levels of CD3+, CD4+ and CD4+/CD8+ in the two groups were increased at 1 month after operation, and the non-anxious group was higher than the anxious group(P<0.05). The levels of CD8+ in the two groups were decreased at 1 month after operation , and the non-anxious group was lower than the anxious group(P<0.05). 1 month after operation, physiological status, emotional status, social/family status, functional status, additional attention score and total score in the two groups decreased, and the non-anxious group was lower than the anxious group (P<0.05). Conclusion: The incidence of preoperative anxiety in patients undergoing radical mastectomy is high, and its occurrence is affected by many factors such as age, education level, monthly income per capita in the family, marital status, family support, history of general anesthesia, length of hospital stay before operation, which can lead to prolonged recovery time and decreased cellular immune function and quality of life. |
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