胆囊炎患者腹腔镜术前焦虑抑郁的发生率及相关因素

目的研究胆囊炎患者腹腔镜术前焦虑抑郁的发生率及其相关因素,为早期干预提供依据。方法通过调查2013年1-12月我院收治的择期行腹腔镜胆囊切除术(LC)的胆囊炎患者65例,采用抑郁自评量表(SDS)、焦虑自评量表(SAS)和自行设计的一般情况问卷调查,了解其焦虑抑郁发生情况,采用单因素和多因素logistic回归对焦虑抑郁发生的影响因素进行分析。结果共调查65名行LC的胆囊炎患者,焦虑/抑郁的发生率为26.2%;男性焦虑/抑郁的发生率为14.7%,显著低于女性患者35.3%(χ2=4.84,P0.05)。单因素logistic回归分析,焦虑/抑郁与非焦虑/抑郁患者在性别(OR=1.709)、文化程度(OR=1.436)、病程(OR=1.889)、职业(OR=1.924)、经济收入(OR=2.018)、家庭支持(OR=2.465)、伴随疾病(OR=1.587)、医疗费用支付情况(OR=2.076)8个因素差异有统计学意义(P0.05);多因素非条件logistic回归分析,女性(OR=1.99)、病程(OR=1.71)是腹腔镜术前焦虑/抑郁发病的危险因素,文化程度(OR=-0.27)、经济收入(OR=-0.32)是保护因素(P0.05)。结论胆囊炎患者腹腔镜术前心理健康水平普遍较为低下,适当进行心理疏导及抗抑郁治疗对顺利渡过围手术期,改善术后生活质量有积极意义。

Analysis of Incidence and Related Factors of Anxiety and Depression in Cholecystitis before Laparoscopic Cholecystectomy

Objective To investigate the incidence and related factors of anxiety and depression in cholecystitis before laparoscopic cholecystectomy（LC）,andprovidebasisforearlyintervention.Methods 65patientswhoscheduledforLCinourhospitalfrom2013.1 to 2013.12 were involved.Self-rating depression scale （SDS）,self-rating anxiety scale （SAS） and self-designed general condition questionnaire were used to record the incidence of anxiety and depression ,and influence factors of depression in cholecystitis was ana-lyzed by univariate analysis and multivariate logistic analysis .Results The incidence of anxiety/depression was 26.2%.The incidence for the males was significantly lower than that for the females （14.7%vs.35.3%） （χ2 =4.84,P＜0.05）.Univariate analysis showed that there was significantly different in gender （OR=1.709）,education level（OR=1.436）,course of diseases（OR=1.889）,occupa-tion（OR=1.924）,income（OR=2.018）,family support（OR=2.465）,comorbidities（OR=1.587）,medical fee payments（OR=2.076） between anxiety/depression patients and non -anxiety/depression patients（P＜0.05）.Multivariate logistic regression analysis showed that females（OR=1.99）,course of diseases（OR=1.71） were independent risk factors,and education level（OR=-0.27）,in-come（OR=-0.32） were protect factors for depression .Conclusion The mental health in cholecystitis before LC is in low level ,psycho-logical counseling and antidepressant treatment can contribute to go through perioperation period smoothly ,and improve the postoperative quality of life .