山东大学耳鼻喉眼学报 ›› 2019, Vol. 33 ›› Issue (4): 76-81.doi: 10.6040/j.issn.1673-3770.0.2018.244

• 论著 • 上一篇    下一篇

142例喉癌术后患者整体睡眠质量状况调查分析

丁洁,孙彦   

  1. 青岛大学附属医院耳鼻咽喉头颈外科, 山东 青岛 266000
  • 出版日期:2019-07-20 发布日期:2019-07-22

Survey of overall sleep quality in 142 patients with laryngectomy

DING Jie, SUN Yan   

  1. Department of Otorhinolaryngology Head and Neck Surgery, Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong, China
  • Online:2019-07-20 Published:2019-07-22

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摘要： 目的 了解喉癌术后患者整体睡眠质量状况。 方法 以2015年5月至12月就诊于青岛大学附属医院耳鼻咽喉头颈外科门诊复查的142例喉癌术后患者(实验组)和48例查体健康者(对照组)为研究对象,采用匹兹堡睡眠质量指数(PSQI)、睡眠状况自评量表(SRSS)对其进行问卷调查,调查结果量化评分,并进行统计学分析。 结果 实验组与对照组PSQI总分分别为(7.20±3.84)、(4.42±1.61)分,二者比较差异有统计学意义(P<0.001)。实验组与对照组SRSS总分分别为(24.92±5.80)、(18.27±3.39)分,二者比较差异有统计学意义(P<0.001)。放化疗者与非放化疗者PSQI总分分别为(7.65±4.39)、(6.92±3.45)分,二者比较差异无统计学意义(P=0.295);放化疗与非放化疗者SRSS总分分别为(25.56±6.11)、(24.52±5.60)分,二者比较差异无统计学意义(P=0.297)。喉部分切除术后拔管者、喉部分切除术后未拔管者、喉全切除术后者PSQI总分分别为(6.90±3.33)、(8.80±5.44)、(7.20±3.98)分,三者比较差异无统计学意义(P=0.215);三者SRSS总分分别为(24.05±4.92)、(27.80±8.00)、(25.40±6.10)分,三者比较差异无统计学意义(P=0.055)。142例喉癌患者中92例存在不同程度的疼痛不适,占64.79%;135例有口腔干燥、次数不等的夜间如厕情况,占95.07%;112例有醒来后再次入睡困难的情况,占78.87%。 结论 喉癌患者术后整体睡眠质量较差,导致睡眠质量低下的主要原因为疾病本身造成的躯体痛苦和心理障碍、治疗导致的后遗症及合并症。

关键词: 喉肿瘤, 外科手术, 睡眠质量

Abstract: Objective To investigate sleep quality in post-laryngectomy patients. Methods In total, 142 post-laryngectomy patients and 48 healthy controls were recruited into this study between May 2015 and February 2016 from the Department of Otorhinolaryngology & Head and Neck Surgery of the Affiliated Hospital of Qingdao University. The Pittsburgh Sleep Quality Index(PSQI)and SRSS were used to evaluate sleep quality and the results of these measures were statistically analyzed. Results Both the average PSQI score and the average SRSS score were higher in the experimental group(7.20±3.84, and 24.92±5.80, respectively)than the control group(4.42±1.61, 18.27±3.39, respectively, P<0.01). The average PSQI score in patients who received chemoradiotherapy after laryngectomy(7.65±4.39), did not significantly differ from the score of those who did not(6.92±3.45, P=0.295). Similarly, the average SRSS score in patients who received chemoradiotherapy after laryngectomy(25.56±6.11)did not significantly differ from the score of those who did not(24.52±5.60, P=0.297). The average PSQI scores of patients who underwent extubation after partial laryngectomy, non-extubation after partial laryngectomy, or total laryngectomy(6.90±3.33, 8.80±5.44, 7.20±3.98, respectively)were not significantly different from one another(P=0.215). There were similarly no significant differences between the average SRSS scores of patients who underwent extubation after partial laryngectomy, non-extubation after partial laryngectomy, or total laryngectomy(24.05±4.92, 27.80±8.00, 25.40±6.10, respectively, P=0.055). In 142 cases of post-laryngectomy, 92 cases(64.79%)had differing degrees of pain and discomfort, 135 patients(95.07%)reported dry mouth and using the toilet at night, and 112 patients(78.87%)had difficulty falling asleep after waking up. Conclusion The overall sleep quality of post-laryngectomy patients is poor. The main causes of poor sleep quality are physical pain, psychological disorders caused by the disease itself, and sequelae and complications caused by treatment.

Key words: Laryngeal neoplasms, Surgical procedures, operative, Sleep quality

中图分类号: 

  • R739.65
[1] TsaySL, Rong JR, LinPF. Acupoints massage in improving the quality of sleep and quality of sleep and quality of life in patients with end-stage renal disease[J]. J Adv Nurs, 2003,42(2):134-142.
[2] 汪向东.心理卫生评定量表手册[M].北京:中国心理卫生杂志社,1999:375-378.
[3] 李建明,尹素凤,段建勋,等.睡眠状况自评量表(SRSS)[J].健康心理学杂志,2000,8(3):351-353.
[4] Duffy SA, Khan MJ, Ronis DL, et al. Health behaviors of head and neck cancer patients the first year after diagnosis[J]. Head Neck, 2008, 30(1):93-102.
[5] Jellema AP, Slotman BJ, Doornaert P, et al. Impact of radiation-induced xerostomia on quality of life after primary radiotherapy anong patients with head and neck cancer[J]. Int J Radiat Oncol Biol Phys, 2007, 69(3):751-760.
[6] Rogers LQ, Courneya KS, Robbins KT, et al. Factors associated with fatigue,sleep,and cognitive function among patients with head and neck cancer[J]. Head Neck, 2008, 30(10):1310-1317.
[7] Mystakidou K, Parpa E, Tsilika E, et al. The relationship of subjective sleep quality, pain, and quality of life in advanced cancer patients[J]. Sleep, 2007, 30(6):737-742.
[8] McMillan SC, Tofthagen C, Morgan MA. Relationships among pain,sleep disturbances,and depressive symptoms in outpatients from a comprehensive cancer center[J]. Oncol Nurs Forum, 2008, 35(4):309-318.
[9] Massie MJ. Prevalence of depression in patients with cancer[J]. J Natl Cancer Inst Monogr, 2004, 32(6):57-71.
[10] Boscolo-Rizzo P, Maronato F, Marchiori C, et al. Long-term quality of life after total laryngectomy and postoperative radiotherapy versus concurrent chemoradiotherapy for laryngeal preservation[J]. Laryngoscope, 2008, 118(2):300-306.
[11] Rada R. Obstructive sleep apnea and head and neck neoplasms[J]. Otolaryngol Head Neck Surg, 2005, 132(5):794-799.
[12] Andrew G, Sonia A, David L, et al. Predictors of Poor Sleep Quality Among Head and Neck Cancer Patients[J]. Laryngoscope, 2010, 120(6):1166-1172.
[13] Stein MB, Belik SL, Jacobi F, et al. Impairment associated with sleep problems in the community: relationship to physical and mental health comorbidity[J]. Psychosom Med, 2008, 70(8):913-919.
[14] Lu K, Chen J, Wu S, et al. Interaction of Sleep Duration and Sleep Quality on Hypertension Prevalence in Adult Chinese Males[J]. J Epidemiol, 2015, 25(6):415-422.
[15] Bruno RM, Palagini L, Gemignani A, et al. Poor sleep quality and resistant hypertension[J]. Sleep Medicine, 2013, 14(11):1157-1163.
[16] De Boer MF, McCormick LK, Pruyn JFA, et al. Physical and psychosocial correlates of head and neck cancer: a review of the lit erature[J]. Otolaryngol Head Neck Surg, 1999, 120(3):427-436.
[17] Sateia MJ, Lang BJ. Sleep and cancer:recent developments[J]. Curr Oncol Rep, 2008, 10:309-318.
[18] McCall VW, Reboussin BA, Cohen W. Subjective messurement of insomnia and quality of life in depressed inpatients[J]. J Sleep Res, 2000, 9(1):43-48.
[19] Tsuno N, Besset A, Ritchie K. Sleep and depression[J]. J Clin Psychiatry, 2005, 66(5):1254-1269.
[20] Galm T, Kulkarni A, Ahmad I. Laryngeal carcinoma metastasis to the orbit:case report[J]. J Laryngol Otol, 2011, 125(5):533-535.
[21] Zhang L, Samet J, Caffo B, et al. Cigarette smoking and nocturnal sleep architecture[J]. Am J Epidemiol, 2006, 164(6):529-537.
[22] Lobo LL, Tufik S. Effects of alcohol on sleep parameters of sleep-deprived healthy adults[J]. Sleep, 1997, 20(1):52-59.
[23] Duffy SA, Ronis DL, McLean S, et al. Pretreatment health behaviors predict survival among patients with head and neck squamous cell carcinoma[J]. J Clin Oncol, 2009, 27(12):1969-1975.
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