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卵巢癌患者围手术期负面情绪的危险因素分析及其对预后的影响。

Analysis of risk factors for negative emotions in perioperative period of ovarian cancer patients and their impact on prognosis.

作者信息

He Jing, Zhang Yang

机构信息

Department of Gynecology, The Affiliated Hospital of Jiangnan University, Wuxi, China.

Department of Gynecology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, China.

出版信息

Gland Surg. 2023 Apr 28;12(4):492-507. doi: 10.21037/gs-23-94. Epub 2023 Apr 18.

Abstract

BACKGROUND

Ovarian cancer (OC), a common malignant tumor of the female reproductive system, has the highest mortality rate among gynecologic cancers. Female patients often experience negative emotions such as anxiety and depression due to sex hormone disorders, fear of cancer, and unfamiliarity with the hospital environment. This study aimed to elucidate the risk factors of negative emotions in the perioperative period of OC patients and their effect on prognosis to provide a reference basis for improving patients' prognosis.

METHODS

We retrospectively analyzed the data of 258 patients with OC at our hospital between August 2014 and December 2019. The -test and chi-square test were used to analyze the relationship between patients' negative emotions and prognosis. Binary logistic regression was used to analyze the independent risk factors for the occurrence of negative emotions and poor prognosis in patients.

RESULTS

Binary logistic regression analysis showed that young age, low monthly household income, low education, no children, lymph node metastasis, postoperative chemotherapy, time to postoperative bowel function recovery ≥24 hours, and the presence of postoperative complications such as irregular bleeding and pressure sores were independent risk factors for negative emotions in patients. Furthermore, negative emotions were found to be an important independent risk factor for patients' prognosis. In patients with negative emotions, the survival rate at 2 and 3 years after surgery was significantly lower compared with patients without negative emotions, and the recurrence rate at 3 years after surgery was significantly higher than in patients without negative emotions.

CONCLUSIONS

In the perioperative period of OC, patients are prone to anxiety, depression, and other psychological disorders, which seriously affect the treatment effect. Therefore, in clinical work, patients' negative emotions should be predicted as early as possible, and active communication with patients and timely psychological counseling should be provided. Improve surgical accuracy and reduce the complication rate.

摘要

背景

卵巢癌(OC)是女性生殖系统常见的恶性肿瘤,在妇科癌症中死亡率最高。女性患者常因性激素紊乱、对癌症的恐惧以及对医院环境的不熟悉而出现焦虑和抑郁等负面情绪。本研究旨在阐明OC患者围手术期负面情绪的危险因素及其对预后的影响,为改善患者预后提供参考依据。

方法

回顾性分析2014年8月至2019年12月我院收治的258例OC患者的数据。采用t检验和卡方检验分析患者负面情绪与预后的关系。采用二元逻辑回归分析患者出现负面情绪和预后不良的独立危险因素。

结果

二元逻辑回归分析显示,年龄小、家庭月收入低、文化程度低、无子女、淋巴结转移、术后化疗、术后肠功能恢复时间≥24小时以及出现术后并发症如不规则出血和压疮等是患者负面情绪的独立危险因素。此外,负面情绪是患者预后的重要独立危险因素。有负面情绪的患者术后2年和3年的生存率明显低于无负面情绪的患者,术后3年的复发率明显高于无负面情绪的患者。

结论

在OC围手术期,患者容易出现焦虑、抑郁等心理障碍,严重影响治疗效果。因此,在临床工作中,应尽早预测患者的负面情绪,并与患者积极沟通,及时提供心理咨询。提高手术准确性,降低并发症发生率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75f6/10186174/e7b6f8c913b3/gs-12-04-492-f1.jpg

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