医药学论文：心理干预对晚期胃癌患者伴发焦虑抑郁的影响

［摘 要］ 目的：胃癌患者和其他恶性肿瘤一样，可以导致患者出现明显的焦虑或抑郁情绪，本文探讨心理干预对晚期胃癌患者伴发的焦虑抑郁的影响。方法：92例伴发焦虑抑郁的晚期胃癌患者随机分为心理干预组(44例)和对照组(48例)，心理干预组接受心理干预联合常规药物治疗，对照组只接受常规药物治疗，两组患者均采用抑郁和焦虑自评量表(SDS、SAS) 作为治疗效果的测查指标。结果：心理干预组抑郁指数在治疗后比治疗前显著下降(39.8±4.5&56.8±4.8，P< 0.01)；焦虑指数也显著下降(36.7±5.1&59.8±4.9，P< 0.01)，而对照组治疗后比治疗前抑郁指数下降不明显(53.4±5.3&57.1±5.6，P>0.05)，焦虑指数下降较明显(47.7±5.3& 60.2±6.8，P< 0.05)，但在治疗后两组组间比较两项指数，对照组均明显高于心理干预组(P< 0.05)。结论：心理干预对晚期胃癌患者的整体康复有促进作用。

 

　　［关键词］ 胃癌；焦虑；抑郁；心理干预

 

　　Influence of Pychology Intervention to Advanced Gastric Cancer Patient with Anxiety and Depression

 

 

 

Abstract： Objective Anxiety and depression emotion prevail among Gastric Cancer patients as other tumors．To study the influence of psychology intervention to Advanced Gastric Cancer tumors with anxiety and depression. Methods 92 patients with anxity and depression after Advanced Gastric Cancer were divided into two groups randomly: the Psychological intervention group (44 cases) receivedboth Psychological intervention therapy and routine drug therapy; the control group (48 cases)received only routine drug therapy; the SelfRating Depression Scale (SDS) and the SelfRating Anxiety Scale (SAS) were used as indicators for measuring the results of treatment in two groups patients. Results The SDS in posttherapy patients was significantly lower than pretherapy patients in the psychology intervention group (39.8±4.5 & 56.8±4.8，P< 0.01). The SAS in posttherapy patients was significantly lower than pretherapy patients in the psychology intervention group (36.7±5.1 & 59.8±4.9，P< 0.01). The SDS had no statistical difference between posttherapy patients with pretherapy patients in the controlled groups(53.4±5.3 & 57.1±5.6，P>0.05). The SAS in posttherapy patients was significantly lower than pretherapy patients in the the controlled groups(47.7±5.3 & 60.2±6.8，P< 0.05). Both SDS and SAS in the controlled groups were significantly higher than the psychology intervention group in posttherapy(P< 0.05).Conclusion Psychology intervention played an advanced role in whole rehabilitation of Advanced Gastric Cancer patient.

 

 

　　Key words：Gastric cancer;Anxiety ; Depression; Psychological intervention

 

　　胃癌及其治疗手段如手术、化疗、放射治疗均可引起不同程度的负性情绪反应如焦虑、抑郁等，这些负性情绪反应使患者常丧失治疗信心，从而对疾病的康复及预后产生不良影响。本文对晚期胃癌患者进行观察研究，从心理学角度探讨了心理干预对该病康复的影响。

 

　　1 对象和方法

 

　　1.1 设计 随机对照研究。

 

　　1.2 研究对象 2004年1月至2006年9月我院收治晚期胃癌患者106例，纳入92例，其中男71例，女21例。年龄31岁~75岁，平均年龄52.3岁。病程1个月~10个月，中位病程为4.8个月。随机分为心理干预组(44例)、对照组(48例)。纳入标准：年龄在18岁以上；确诊为晚期胃癌；小学及以上文化程度；意识清、智能正常，能配合完成量表检查；焦虑及抑郁指数(焦虑、抑郁指数=实测总分/80×100%)≥50%［1］者。排出标准：既往无精神疾病史；无精神病阳性家族史。