中华肝脏外科手术学电子杂志
中華肝髒外科手術學電子雜誌
중화간장외과수술학전자잡지
CHINESE JOURNAL OF HEPATIC SURGERY(ELECTRONIC EDITION)
2015年
2期
92-96
,共5页
顾华英%林颖%潘淑茹%吴斌%温盛霖%韩洪瀛
顧華英%林穎%潘淑茹%吳斌%溫盛霖%韓洪瀛
고화영%림영%반숙여%오빈%온성림%한홍영
肝硬化%肝移植%焦虑%抑郁%认知
肝硬化%肝移植%焦慮%抑鬱%認知
간경화%간이식%초필%억욱%인지
Liver cirrhosis%Liver transplantation%Anxiety%Depression%Cognition
目的：探讨肝硬化患者肝移植手术前后情绪状态和认知功能的变化。方法本前瞻性研究对象为2012年9月至2013年9月在中山大学附属第三医院收治的26例肝硬化肝移植术前患者和24例肝硬化肝移植术后患者，另取26例健康体检者作正常对照组。所有研究对象均签署知情同意书，符合医学伦理学规定。将肝移植术前患者设为术前组，其中男23例，女3例；平均年龄（50±9）岁。将肝移植术后1个月患者设为术后组，其中男22例，女2例；年龄（50±6）岁。正常对照组男23例，女3例；年龄（49±9）岁。分别收集3组临床资料，对研究对象进行精神心理状态评定及认知功能检查，包括汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）、数字连线试验A（NCT-A）、数字符号试验（DST）。多组间比较采用单因素方差分析，两两比较采用LSD-t检验。结果术前组HAMD评分、HAMA评分、NCT-A测试结果、DST评分分别为（16.2±3.5）分、（17±5）分、（56±13）s、（36±11）分；术后组相应为（14.2±3.7）分、（16±3）分、（52±12）s、（42±7）分；正常对照组相应为（7.3±2.4）分、（8±3）分、（38±8）s、（54±9）分。与正常对照组相比，术前组HAMD、HAMA评分及NCT-A测试结果明显升高（LSD-t=11.919，8.596，6.883；P<0.05），DST评分明显降低（LSD-t=-6.972，P<0.05）。与正常对照组相比，术后组HAMD、HAMA评分及NCT-A测试结果明显升高（LSD-t=8.591，9.942，5.475；P<0.05），DST评分明显降低（LSD-t=-5.599，P<0.05）。与术前组相比，术后组HAMD评分明显降低（LSD-t=-2.209，P<0.05），DST评分明显升高（LSD-t=1.243，P<0.05）。结论肝硬化患者肝移植术前存在明显的抑郁、焦虑及认知功能障碍，肝移植术后1个月内患者抑郁状况及认知功能明显好转，但尚未恢复至正常水平，焦虑状况改善不明显。
目的：探討肝硬化患者肝移植手術前後情緒狀態和認知功能的變化。方法本前瞻性研究對象為2012年9月至2013年9月在中山大學附屬第三醫院收治的26例肝硬化肝移植術前患者和24例肝硬化肝移植術後患者，另取26例健康體檢者作正常對照組。所有研究對象均籤署知情同意書，符閤醫學倫理學規定。將肝移植術前患者設為術前組，其中男23例，女3例；平均年齡（50±9）歲。將肝移植術後1箇月患者設為術後組，其中男22例，女2例；年齡（50±6）歲。正常對照組男23例，女3例；年齡（49±9）歲。分彆收集3組臨床資料，對研究對象進行精神心理狀態評定及認知功能檢查，包括漢密爾頓抑鬱量錶（HAMD）、漢密爾頓焦慮量錶（HAMA）、數字連線試驗A（NCT-A）、數字符號試驗（DST）。多組間比較採用單因素方差分析，兩兩比較採用LSD-t檢驗。結果術前組HAMD評分、HAMA評分、NCT-A測試結果、DST評分分彆為（16.2±3.5）分、（17±5）分、（56±13）s、（36±11）分；術後組相應為（14.2±3.7）分、（16±3）分、（52±12）s、（42±7）分；正常對照組相應為（7.3±2.4）分、（8±3）分、（38±8）s、（54±9）分。與正常對照組相比，術前組HAMD、HAMA評分及NCT-A測試結果明顯升高（LSD-t=11.919，8.596，6.883；P<0.05），DST評分明顯降低（LSD-t=-6.972，P<0.05）。與正常對照組相比，術後組HAMD、HAMA評分及NCT-A測試結果明顯升高（LSD-t=8.591，9.942，5.475；P<0.05），DST評分明顯降低（LSD-t=-5.599，P<0.05）。與術前組相比，術後組HAMD評分明顯降低（LSD-t=-2.209，P<0.05），DST評分明顯升高（LSD-t=1.243，P<0.05）。結論肝硬化患者肝移植術前存在明顯的抑鬱、焦慮及認知功能障礙，肝移植術後1箇月內患者抑鬱狀況及認知功能明顯好轉，但尚未恢複至正常水平，焦慮狀況改善不明顯。
목적：탐토간경화환자간이식수술전후정서상태화인지공능적변화。방법본전첨성연구대상위2012년9월지2013년9월재중산대학부속제삼의원수치적26례간경화간이식술전환자화24례간경화간이식술후환자，령취26례건강체검자작정상대조조。소유연구대상균첨서지정동의서，부합의학윤리학규정。장간이식술전환자설위술전조，기중남23례，녀3례；평균년령（50±9）세。장간이식술후1개월환자설위술후조，기중남22례，녀2례；년령（50±6）세。정상대조조남23례，녀3례；년령（49±9）세。분별수집3조림상자료，대연구대상진행정신심리상태평정급인지공능검사，포괄한밀이돈억욱량표（HAMD）、한밀이돈초필량표（HAMA）、수자련선시험A（NCT-A）、수자부호시험（DST）。다조간비교채용단인소방차분석，량량비교채용LSD-t검험。결과술전조HAMD평분、HAMA평분、NCT-A측시결과、DST평분분별위（16.2±3.5）분、（17±5）분、（56±13）s、（36±11）분；술후조상응위（14.2±3.7）분、（16±3）분、（52±12）s、（42±7）분；정상대조조상응위（7.3±2.4）분、（8±3）분、（38±8）s、（54±9）분。여정상대조조상비，술전조HAMD、HAMA평분급NCT-A측시결과명현승고（LSD-t=11.919，8.596，6.883；P<0.05），DST평분명현강저（LSD-t=-6.972，P<0.05）。여정상대조조상비，술후조HAMD、HAMA평분급NCT-A측시결과명현승고（LSD-t=8.591，9.942，5.475；P<0.05），DST평분명현강저（LSD-t=-5.599，P<0.05）。여술전조상비，술후조HAMD평분명현강저（LSD-t=-2.209，P<0.05），DST평분명현승고（LSD-t=1.243，P<0.05）。결론간경화환자간이식술전존재명현적억욱、초필급인지공능장애，간이식술후1개월내환자억욱상황급인지공능명현호전，단상미회복지정상수평，초필상황개선불명현。
ObjectiveTo investigate the change of mood and cognitive function of patients with liver cirrhosis before and after liver transplantation (LT).MethodsA total of 26 patients with liver cirrhosis before LT and 24 patients after LT admitted in the Third Afifliated Hospital of Sun Yat-sen University from September 2012 to September 2013 were included in this prospective study. Moreover, 26 healthy controls were also included in normal control group. The informed consents of all participants were obtained and the local ethical committee approval had been received. The 26 patients before LT were assigned in preoperative group, among them, 23 were males and 3 were females with the average age of (50±9) years old. The 24 patients after LT were assigned in postoperative group, among them, 22 were males and 2 were females with the average age of (50±6) years old. Among the healthy controls, 23 were males and 3 were females with the average age of (49±9) years old. Clinical data of the three groups were collected respectively. The mood status and the cognitive function of the participants were assessed with Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Scale (HAMA), Number Connection Test A (NCT-A) , Digit Symbol Test (DST). The results of multiple groups were compared with one-way analysis of variance and pairwise comparisons were conducted with LSD-t test.ResultsThe HAMD, HAMA scores, NCT-A results and DST scores of the preoperative group were (16.2±3.5), (17±5), (56±13) s and (36±11) and those of the postoperative group were (14.2±3.7), (16±3), (52±12) s and (42±7) and those of the normal control group were (7.3±2.4), (8±3), (38±8) s and (54±9). Compared with the normal control group, the HAMD, HAMA scores and NCT-A results of the preoperative group increased significantly (LSD-t=11.919, 8.596, 6.883;P<0.05) and the DST scores decreased significantly (LSD-t=-6.972,P<0.05). Compared with the normal control group, the HAMD, HAMA scores and NCT-A results of the postoperative group increased significantly (LSD-t=8.591, 9.942, 5.475;P<0.05) and the DST scores decreased significantly (LSD-t=-5.599,P<0.05). Compared with preoperative group, the HAMD scores of the postoperative group decreased significantly (LSD-t=-2.209,P<0.05) and the DST scores increased significantly (LSD-t=1.243,P<0.05).ConclusionsPatients with liver cirrhosis have obvious depression, anxiety and cognitive disorder before LT. A month after LT, depression and cognitive disorder improve obviously, but cannot recover to the normal level. The anxiety improvement is not obvious.
