Yin Rong, Xu Shasha, Zhu Jing, Zhu Haiou, He Chao
Department of Hepatobiliary Center Ward II, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China.
Int J Gen Med. 2023 Dec 11;16:5841-5853. doi: 10.2147/IJGM.S440469. eCollection 2023.
Hilar cholangiocarcinoma (HCCA) is a common malignant tumor of the biliary system. Factors such as limited physical function, intractability, and high mortality caused by the tumor lead to negative emotions, such as anxiety and depression in patients. In this study, we investigated the risk factors for negative emotions in patients undergoing radical resection of HCCA during the perioperative period and its effect on prognosis to provide strategies for alleviating the negative emotional disorders of patients and improving prognosis.
From September 2016 to August 2021, we retrospectively examined 205 patients with HCCA who underwent radical resection in our hospital. The incidence of negative emotions and the clinical parameters of patients were compared using Chi-square tests and -tests. The independent risk factors for unfavorable feelings in patients during the perioperative period were determined using binary logistic regression. The key variables influencing the postoperative survival status of HCCA patients were identified using the log-rank univariate analysis and Cox proportional risk regression analysis.
The results of the binary logistic regression analysis showed that perioperative negative emotions were independently influenced by family monthly income (OR = 0.069), medical insurance (OR = 0.089), family care (OR = 0.013), sleep quality (OR = 0.071), TNF-α (OR = 5.851), and bile leakage (OR = 29.412) (P < 0.05). The age of the patient (OR = 2.003), preoperative CA19-9 (OR = 2.038), lymph node metastases (OR = 2.327), and negative mood (OR = 3.054) were independent risk variables that affected the survival status of patients, as determined by the results of Cox regression analysis (P < 0.05).
In this study, we found that anxiety and depression in patients undergoing radical operation of HCCA are related to family monthly income, medical insurance, sleep quality, family care, TNF-α, and bile leakage; also, negative emotions have adverse effects on prognosis.
肝门部胆管癌（HCCA）是胆道系统常见的恶性肿瘤。肿瘤导致的身体功能受限、难治性及高死亡率等因素会使患者产生焦虑和抑郁等负面情绪。在本研究中，我们调查了HCCA根治性切除患者围手术期负面情绪的危险因素及其对预后的影响，以提供缓解患者负面情绪障碍和改善预后的策略。
2016年9月至2021年8月，我们回顾性分析了在我院接受根治性切除的205例HCCA患者。采用卡方检验和t检验比较患者负面情绪的发生率和临床参数。使用二元逻辑回归确定围手术期患者不良情绪的独立危险因素。使用对数秩单因素分析和Cox比例风险回归分析确定影响HCCA患者术后生存状况的关键变量。
二元逻辑回归分析结果显示，围手术期负面情绪受家庭月收入（OR = 0.069）、医疗保险（OR = 0.089）、家庭关怀（OR = 0.013）、睡眠质量（OR = 0.071）、TNF-α（OR = 5.851）和胆漏（OR = 29.412）的独立影响（P < 0.05）。Cox回归分析结果显示，患者年龄（OR = 2.003）、术前CA19-9（OR = 2.038）、淋巴结转移（OR = 2.327）和负面情绪（OR = 3.054）是影响患者生存状况的独立风险变量（P < 0.05）。
在本研究中，我们发现HCCA根治手术患者的焦虑和抑郁与家庭月收入、医疗保险、睡眠质量、家庭关怀、TNF-α和胆漏有关；此外，负面情绪对预后有不良影响。
