Journal of Prevention and Treatment for Stomatological Diseases ›› 2019, Vol. 27 ›› Issue (11): 723-728.doi: 10.12016/j.issn.2096-1456.2019.11.007

• Prevention and Treatment Practice • Previous Articles     Next Articles

Depression status of 136 patients with adjuvant radiotherapy after reconstruction of the oral cancer flap and analysis of influencing factors

WANG Cuiping1,WANG Mengxi1,LV Bo2()   

  1. 1. Department of Stomatology, the Fourth Affiliated Hospital of Harbin Medical University, Harbin 150001, China
    2. Oral Care Teaching and Research Office, Heilongjiang Nursing College, Harbin 150001, China
  • Received:2018-12-05 Revised:2019-05-22 Online:2019-11-20 Published:2019-12-03

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Abstract: Objective To explore the depression and influencing factors of patients with adjuvant radiotherapy after reconstruction of oral cancer flaps and to provide evidence for postoperative care. Methods One hundred thirty-six patients with oral cancer who had undergone adjuvant radiotherapy after reconstruction of skin flaps at 4 affiliated hospitals in Harbin Medical University were selected by convenience sampling. The basic information of the patients with adjuvant radiotherapy after reconstruction of skin flaps was collected, a self-rating scale for depression was used to assess depression, and a questionnaire was used to assess symptom distress. Depression and its influencing factors were determined by multiple stepwise regression analysis. Results The average score of depression in patients with oral cancer after skin flap reconstruction was (52.32±13.11): 33.1% of the patients showed mild depression, 21.3% showed moderate depression, and 2.2% showed severe depression. Postoperatively, the patients had pain, dysphagia, taste disorders, temporomandibular joint and salivary gland dysfunction, as well as marital and financial problems. The results showed that dysphagia (P < 0.001), taste disorder (P < 0.001), marital status (P=0.004) and family income per month (P= 0.011) could be the influencing factors of depression in patients with oral cancer during radiotherapy, and a significant correlation was found between them. Conclusion Patients with adjuvant radiotherapy after reconstruction of oral cancer flaps have depressive symptoms, which will seriously affect the quality of life. Therefore, the care of such patients should focus on improving the postoperative depression of patients.

Key words: oral cancer, flap reconstruction, radiotherapy, depression, influencing factors, dysfunction, economic income, nursing

CLC Number: 

  • R782

Table 1

Basic information of the selected patients"

项目类别例数比例（%）
性别男8965.4
女4734.6
婚姻状况已婚11786.0
未婚/离异/丧偶1914.0
教育程度大专及以上4230.9
中学6447.1
小学及以下3022.0
家庭人均月收入（元）>5 0006346.3
4 999~3 0002316.9
<3 0005036.8
医保状况省医保2216.2
市医保5137.5
新农合3727.2
自费2619.1
吸烟是11886.8
否1813.2
饮酒是9166.9
否4533.1
癌症位置唇部75.1
颊黏膜5943.4
舌4230.9
牙龈96.6
磨牙后10.8
硬腭1813.2
癌症分期Ⅰ期1511.0
Ⅱ期2316.9
Ⅲ期4432.4
Ⅳ期5439.7
治疗方案手术+放疗10476.5
手术+放疗+化疗3223.5
放疗次数3次6245.6
4次7454.4

"

项目n抑郁得分t或FP
婚姻状况在婚11752.13±13.489.793<0.001
非在婚1953.53±10.77
家庭人均月收入（元）>5 0006348.76±12.8047.067<0.001
4 999~3 0002350.30±11.14
<3 0005055.37±13.36
医疗费用支付方式省医保2248.45±14.272.8920.034
市医保5152.12±12.15
新农合3753.24±13.24
自费2654.69±13.74
吸烟是11850.99±13.425.550<0.001
否1861.06±5.63
癌症分期Ⅰ1549.62±11.018.492<0.001
Ⅱ2347.44±12.65
Ⅲ4452.45±13.94
Ⅳ5456.47±11.62

Table 3

Correlation between symptom severity and depression in patients with adjuvant radiotherapy after reconstruction of the oral cancer flap n = 136"

症状严重程度评分例数严重程度平均得分（x ± s）相关系数P
疼痛无0820.63±0.830.577<0.001
轻微18
中度231
重度315
吞咽困难无0191.80±1.140.766<0.001
吞咽不适,饮食不受干扰130
吞咽困难,需要食用软食257
吞咽相当困难,仅能进食液体315
吞咽液体严重困难415
味觉障碍无0530.85±0.780.820<0.001
部分丧失151
完全丧失232
牙关紧闭无000.85±0.740.2910.001
轻微159
中度223
重度354
口腔干燥无081.36±0.950.587<0.001
轻微142
中度263
重度323

Table 4

Multivariate stepwise regression analysis of factors affecting depression in patients with adjuvant radiotherapy after reconstruction of the oral cancer flap n = 136"

自变量BBEβFP95%CI
常数48.5293.155—15.381<0.00142.287 ~ 54.770
味觉障碍7.1350.9150.4247.800<0.0015.325 ~ 8.944
吞咽困难4.3730.5900.3807.407<0.0013.205 ~ 5.541
婚姻状况-3.8181.290-0.144-2.9600.004-6.370 ~ -1.266
家庭人均月收入-1.8680.723-0.128-2.5830.011-3.298 ~ -0.437
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