华西医学

华西医学

胰腺癌全胰切除术后焦虑危险因素分析

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目的 探讨胰腺癌全胰切除患者术后焦虑的危险因素。 方法 回顾性收集 2011 年 7 月—2016 年 12 月 31 例行全胰切除术的胰腺癌患者资料,患者术后焦虑情况通过焦虑自评量表评估,采用 SPSS 21.0 软件进行单因素分析及多因素 logistic 回归分析。 结果 纳入的 31 例患者中,男 17 例,女 14 例,平均年龄(66.16±9.09)岁,体质量指数(21.11±3.10)kg/m2,术后平均住院时间(14.58±7.47)d,术后出现焦虑表现 23 例(74.2%),术后血糖增高需胰岛素治疗 30 例(96.8%),围手术期总体病死率为 3.2%。单因素分析显示,年龄(P=0.012)、吸烟史(P=0.043)、术前合并糖尿病(P=0.012)、术后胆漏(P=0.043)、术后腹腔感染(P=0.026)是术后焦虑的相关因素,多因素 logistic 回归分析显示,术前无糖尿病(P=0.013)是术后焦虑的独立危险因素。 结论 对胰腺癌全胰切除患者,需重视患者术后心理状态,尤其是术前无糖尿病的患者,应积极评估及干预术后焦虑,通过健康宣教及心理干预,提高全胰切除患者的生活质量及远期生存率。

Objective To explore the risk factors of postoperative anxiety in patients with pancreatic cancer undergoing total pancreatectomy. Methods A total of 31 patients who underwent total pancreatectomy for pancreatic cancer between July 2011 and December 2016 were collected and analyzed in this retrospective study. The patients’ postoperative Self-Rating Anxiety Scale scores were collected, and the exposure factors were analyzed to identify the risk factors of postoperative anxiety through univariate analysis and multiple logistic regression analysis by SPSS 21.0 statistical software. Results In the 31 patients, there were 17 males and 14 females, with an average age of (66.16±9.09) years, an average body mass index of (21.11±3.10) kg/m2, and an average postoperative hospital stay of (14.58±7.47) days. There were 23 patients (74.2%) with postoperative anxiety, and 30 patients (96.8%) with hyperglycosemia required insulin therapy. The total perioperative mortality was 3.2%. In the univariate analysis, age (P=0.012), smoking history (P=0.043), preoperative diabetes mellitus (P=0.012), postoperative bile leakage (P=0.043), and postoperative abdominal infection (P=0.026) were related factors of the postoperative anxiety. In the multiple logistic regression analysis, patients without preoperative diabetes was an independent risk factor of postoperative anxiety (P=0.013). Conclusions For patients undergoing total pancreatectomy, it is needed to pay attention to the patients’ postoperative psychological conditions and assess the postoperative anxiety, especially for those without preoperative diabetes. To improve the life quality and long-term survival of these patients, health education and psychological intervention are needed.

关键词: 全胰切除术; 胰腺癌; 围手术期; 术后焦虑; 危险因素

Key words: Total pancreatectomy; Pancreatic cancer; Perioperative period; Postoperative anxiety; Risk factor

引用本文: 胥巧玉, 张浩, 龚姝, 李可洲, 刘续宝. 胰腺癌全胰切除术后焦虑危险因素分析. 华西医学, 2018, 33(4): 431-434. doi: 10.7507/1002-0179.201803037 复制

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