| 夏宏全,曾小凤,黄肇晶,孙 硕,程艳双,张东勇.脑胶质瘤患者术后睡眠障碍的影响因素分析及对认知功能、心理状态和康复进程的影响[J].,2023,(7):1248-1252 |
| 脑胶质瘤患者术后睡眠障碍的影响因素分析及对认知功能、心理状态和康复进程的影响 |
| Analysis of Influencing Factors of Postoperative Sleep Disorder in Patients with Glioma and its Influence on Cognitive Function, Psychological State and Rehabilitation Process |
| 投稿时间：2022-12-07 修订日期：2022-12-30 |
| DOI：10.13241/j.cnki.pmb.2023.07.009 |
| 中文关键词: 脑胶质瘤 睡眠障碍 影响因素 认知功能 心理状态 康复进程 |
| 英文关键词: Glioma Sleep disorder Influencing factors Cognitive function Psychological state Rehabilitation process |
| 基金项目:辽宁省博士科研启动基金（201501004） |
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| 中文摘要: |
| 摘要 目的：分析脑胶质瘤患者术后睡眠障碍的影响因素，并探讨术后睡眠障碍对机体认知功能、心理状态和康复进程的影响。方法：选择2019年4月~2021年12月期间中国医科大学附属第一医院收治的260例脑胶质瘤患者。根据病例资料收集并记录患者基本信息，采用单因素和多因素Logistic回归分析脑胶质瘤患者术后睡眠障碍的影响因素。以匹茨堡睡眠质量指数量表（PSQI）评估所有患者的睡眠质量；以简易智力状态检查量表（MMSE）、蒙特利尔认知评估量表（MoCA）评估所有患者的认知功能；以焦虑自评量表（SAS）评分和抑郁自评量表（SDS）评估所有患者的心理状态。观察睡眠障碍对机体认知功能、心理状态和康复进程的影响。结果：260例脑胶质瘤患者中，出现睡眠障碍的有98例，睡眠障碍发生率为37.69%。根据是否发生睡眠障碍将患者分为睡眠障碍组（n=98）和无睡眠障碍组（n=162）。单因素分析结果显示：脑胶质瘤患者术后睡眠障碍与性别、肿瘤部位、脑胶质瘤病理分级、肿瘤直径、合并疾病数量、术后疼痛评分有关（P<0.05），而与年龄、体质量指数、文化程度、家庭人均月收入、手术时间、术中出血量、肿瘤占位症状、吸烟史、饮酒史、术前卡式功能状态（KPS）评分无关（P>0.05）。多因素Logistic回归分析结果显示：性别为女、合并疾病数量2种及其以上、术后疼痛评分偏高、肿瘤部位为多个脑叶、脑胶质瘤病理分级为Ⅲ级是脑胶质瘤患者术后睡眠障碍的危险因素（P<0.05）。睡眠障碍组的MoCA、MMSE评分均低于无睡眠障碍组（P<0.05）。睡眠障碍组的SAS、SDS评分均高于无睡眠障碍组（P<0.05）。睡眠障碍组的术后恢复进食时间、首次下床活动时间、尿管拔除时间、术后住院时间均长于无睡眠障碍组（P<0.05）。结论：脑胶质瘤患者术后睡眠障碍的发生率较高，性别、术后疼痛评分、合并疾病数量、脑胶质瘤病理分级、肿瘤部位均是睡眠障碍的影响因素，睡眠障碍会影响患者的认知功能，增加抑郁焦虑程度，影响康复进程。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the influencing factors of postoperative sleep disorder in patients with glioma, and to explore the effects of postoperative sleep disorder on cognitive function, psychological state and rehabilitation process. Methods: 260 patients with glioma who were admitted to the First Affiliated Hospital of China Medical University from April 2019 to December 2021 were selected. The basic information of patients was collected and recorded according to the case data. Univariate and multivariate Logistic regression were used to analyze the influencing factors of postoperative sleep disorder in patients with glioma. The sleep quality of all patients was assessed by Pittsburg Sleep Quality Index (PSQI). The Mini Mental State Examination (MMSE) and the Montreal Cognitive Assessment Scale (MoCA) were used to assess the cognitive function of all patients. The psychological state of all patients was evaluated by self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS). The effects of sleep disorder on cognitive function, psychological state and rehabilitation process were observed. Results: Among 260 patients with glioma, 98 had sleep disorder, and the incidence of sleep disorder was 37.69%. The patients were divided into sleep disorder group (n=98) and non sleep disorder group (n=162) according to whether sleep disorder occurred. The results of univariate analysis showed that: postoperative sleep disorder of patients with glioma were correlated with gender, tumor site, glioma pathological grade, tumor diameter, number of complicated diseases, postoperative pain score (P<0.05). However, it was not correlated with age, body mass index, education level, per capita monthly family income, operation time, intraoperative blood loss, tumor space occupying symptoms, smoking history, drinking history and preoperative Karnofsky Performance Status (KPS) score(P>0.05). The results of multivariate Logistic regression analysis showed that the risk factors of sleep disorder in patients with glioma were gender with female, number of combined diseases with 2 kind or more, high postoperative pain score, multiple brain lobes of tumor site, grade Ⅲ of glioma pathological grade (P<0.05). The MoCA and MMSE scores in the sleep disorder group were lower than those in the non-sleep disorder group (P<0.05). The SAS and SDS scores in the sleep disorder group were higher than those in the non-sleep disorder group(P<0.05). The resume eating time after operation, the time to get out of bed for the first time, the time to remove the catheter, and the time to stay in hospital after operation in the sleep disorder group were longer than those in the non-sleep disorder group (P<0.05). Conclusion: Patients with glioma have a high incidence of postoperative sleep disorder, The results of multivariate analysis showed that gender, postoperative pain score, number of complicated diseases, glioma pathological grade, tumor site are all influencing factors of sleep disorder. sleep disorder will affect the cognitive function of patients, increase the degree of depression and anxiety, and affect the rehabilitation process. |
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