本文關(guān)鍵詞：乳腺癌患者化療相關(guān)認(rèn)知障礙及其與抑郁情緒關(guān)系的研究　出處：《安徽醫(yī)科大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 化療 抑郁 認(rèn)知障礙 乳腺癌

【摘要】：目的了解乳腺癌術(shù)后患者經(jīng)過六周期標(biāo)準(zhǔn)方案化療后抑郁的發(fā)生狀況,了解化療前后記憶、注意、執(zhí)行功能等認(rèn)知功能的變化,并進(jìn)一步探討化療后患者抑郁情緒與其認(rèn)知障礙的關(guān)系。方法首先,應(yīng)用抑郁自評量表(SDS)篩選出2013年10月至2014年8月在我院腫瘤科及乳腺外科就診的68例乳腺癌術(shù)后未合并抑郁情緒的患者;其次,采用成套認(rèn)知神經(jīng)心理學(xué)量表對入組患者進(jìn)行化療前認(rèn)知神經(jīng)心理學(xué)評分,并記錄入組患者的一般資料及乳腺癌的臨床資料;最后,在六周期標(biāo)準(zhǔn)方案化療后2周內(nèi)再次對入組患者進(jìn)行抑郁自評量表及認(rèn)知神經(jīng)心理學(xué)方面評估。成套認(rèn)知神經(jīng)心理學(xué)量表包括簡易精神狀況量表(mini-mental state examination,MMSE)、詞語流暢性測驗(yàn)(verbal fluency test,VFT)、聽覺詞語學(xué)習(xí)測驗(yàn)表(auditory words learn test,AVLT)、數(shù)字廣度試驗(yàn)(digit span,DS)和連線測驗(yàn)(trail making test,TMT)。63例乳腺癌患者完成化療前后全部問卷調(diào)查。應(yīng)用SPSS16.0對數(shù)據(jù)進(jìn)行錄入和分析,分析方法包括描述性統(tǒng)計(jì)分析、兩獨(dú)立樣本t檢驗(yàn)、pearson相關(guān)分析等。結(jié)果①與化療前比較,化療后患者在MMSE(27.84±1.73 vs.26.19±1.77,P=0.000)、數(shù)字廣度倒背(4.40±1.02 vs.3.60±0.99,P=0.000)、AVLT3(7.06±0.78vs.6.76±0.86,P=0.002)、AVLT4(3.41±0.99 vs.2.73±0.99,P=0.000)、AVLT5(2.81±0.76 vs.2.16±0.68,P=0.000)、AVLT6(9.19±1.11 vs.8.22±1.16,P=0.000)、TMTA(52.25±1.68 vs.53.54±1.89,P=0.000)和TMTB(98.94±1.89 vs.105.16±2.03,P=0.000)得分降低,差異有統(tǒng)計(jì)學(xué)意義(均P0.05);在SDS得分升高,差異有統(tǒng)計(jì)學(xué)意義(37.44±6.74 vs.48.31±13.09,P0.05)。②本研究中共有63例患者完成問卷調(diào)查,其中29例患者化療后合并抑郁情緒,34例患者不合并抑郁情緒,抑郁發(fā)生率為46.03%。與化療后未合并抑郁患者比較,抑郁組在MMSE、VFT(動物)、VFT(水果)、AVLT1、AVLT4~AVLT6、數(shù)字廣度倒背和TMTB成績差異均有統(tǒng)計(jì)學(xué)意義(分別為t=-5.202、-2.591、-2.435、-3.358、-3.047、-5.822、-3.707、-2.231、3.597;均P0.05),而在AVLT2、AVLT3、數(shù)字廣度順背和TMTA評分成績差異無統(tǒng)計(jì)學(xué)意義(分別為t=-1.251、-1.214、-1.683、0.445,均P0.05)。③抑郁與MMSE、VFT(水果)、AVLT3、數(shù)字廣度順背、數(shù)字廣度倒背、TMTB得分呈中度負(fù)相關(guān),差異有統(tǒng)計(jì)學(xué)意義(分別為r=-0.398、-0.439、-0.441、-0.425、-0.429、-0.483,均P0.05)。結(jié)論①乳腺癌患者術(shù)后化療后存在不同程度的認(rèn)知功能受損,表現(xiàn)為總體認(rèn)知功能、記憶力、注意力及執(zhí)行功能的改變。②乳腺癌術(shù)后化療后患者抑郁發(fā)生率較高,需要臨床醫(yī)護(hù)工作者高度重視。③乳腺癌化療后合并抑郁患者的總體認(rèn)知功能、記憶力、注意力、語言能力、執(zhí)行功能下降情況更為嚴(yán)重,并且抑郁情緒與總體認(rèn)知功能、注意力和執(zhí)行能力存在相關(guān)性,進(jìn)一步說明抑郁情緒會加重乳腺癌患者化療相關(guān)認(rèn)知障礙。
[Abstract]:Objective to understand the prevalence of patients after six cycles of depression after standard chemotherapy after breast cancer surgery, understand the changes before and after chemotherapy and memory, attention, executive function and other cognitive functions, and to further explore the relationship after chemotherapy in patients with depression and cognitive impairment. Methods firstly, using self rating Depression Scale (SDS) were selected to October 2013 in August 2014 with depression in 68 cases of breast cancer, and breast surgery in our hospital treatment of tumor patients after; secondly, the cognitive neuropsychological scale of the patients before chemotherapy cognitive neuropsychology score and clinical data records into groups of patients with general information and breast cancer; finally, in six cycles of chemotherapy after 2 weeks again for the patients by self rating depression scale and cognitive neuropsychological assessment. Cognitive neuropsychological scale including Jian Yijing God Status Scale (Mini-Mental State Examination, MMSE), verbal fluency test (verbal fluency, test, VFT), auditory verbal learning test table (auditory words learn test, AVLT), digital span test (digit span, DS (Trail Making) and trail making test test, TMT) before and after chemotherapy all questionnaires completed.63 cases of breast cancer patients. The application of SPSS16.0 for data analysis, analysis methods including descriptive statistical analysis, two independent samples t test, Pearson correlation analysis. Results compared with before chemotherapy, after chemotherapy in patients with MMSE (27.84 + 1.73 vs.26.19 + 1.77, P=0.000), digital span (4.40 + 1.02 vs.3.60 + 0.99, P=0.000), AVLT3 (7.06 + 0.78vs.6.76 + 0.86, P=0.002), AVLT4 (3.41 + 0.99 vs.2.73 + 0.99, P=0.000), AVLT5 (2.81 + 0.76 vs.2.16 + 0.68, P=0.000), AVLT6 (9.19 + 1.11 vs.8.22 + 1.16, P=0.000), TMTA (52.25 + 1.68 + 1.89 vs.53.54 P=0.000), and TMTB (98.94 + 1.89 + 2.03 vs.105.16, P=0.000) score decreased, the difference was statistically significant (P0.05); increase in the SDS score, the difference was statistically significant (37.44 + 6.74 vs.48.31 + 13.09, P0.05). In this study a total of 63 patients completed the questionnaire, which combined with depression 29 cases of patients after chemotherapy, 34 cases of patients with depression, the depression rate was 46.03%. and after chemotherapy without depression, the depression group in MMSE, VFT (animal), VFT (fruit), AVLT1, AVLT4~AVLT6, digital span and TMTB score differences were statistically significant (respectively t=-5.202, -2.591 -2.435, -3.358, -3.047, -5.822, -3.707, -2.231,3.597, P0.05);, and in AVLT2, AVLT3, digital span difference back and TMTA scores had no statistical significance (t=-1.251, -1.214, -1.683,0.445, P0.05). The depression and MMSE, VFT, AVLT3 (fruit), digital broadcasting Is along the back, digital span, TMTB scores were negatively correlated, the difference was statistically significant (r=-0.398, -0.439, -0.441, -0.425, -0.429, -0.483, P0.05). The postoperative breast cancer patients after chemotherapy conclusion have cognitive dysfunction at various levels, performance for the overall cognitive function and memory. Attention and executive function change. The chemotherapy of postoperative breast cancer patients after the incidence of depression is high, clinical medical workers need attention. The chemotherapy after breast cancer with general cognitive function, depression, memory, attention, language, executive function decline is more serious, and depression and general cognitive function, existence correlation between attention and executive ability, further explained that depression can aggravate the cognitive disorder of chemotherapy in patients with breast cancer.

【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R737.9

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