| Background:Malignant tumor is a major disease endangering human health and life,has gradually become one of the first cause of death in urban residents in our country.Along with the advance of medical technology and development,modern medicine has to shift from "biomedical model" of "biology-psychology-social medical model",a malignant tumor with the patient’s psychological factor relations gradually valued.Studies have found that malignant tumor correlation between depression and anxiety is one of the most common clinical symptoms,is in the process of diagnosis and treatment of tumor patients in the side effects of treatment and relapse metastasis resulting in patients with pathologic emotional response.Malignant tumors in patients with depression can inhibit the body’s immune function,increase pain sensitivity,and aggravate adverse reactions,increases the risk of tumor occurrence,development,recurrence and metastasis,lower the quality of life,the survival fell by 10%-20%,and even some direct causes of death of patients with malignant tumor may not tumor but depressive state.As the extension of malignant tumor patient surial and the popularity of high resolution computed tomography(CT),malignant tumor with pulmonary nodules detection rate is higher,but the malignant tumor with pulmonary nodules reported less relationship with psychological factors,and the past is often seen as the late tumor with chemotherapy treatments,a study shows in recent years,malignant tumor and the incidence of multiple primary lung cancer and tuberculosis gradually rise,there is also evidence that surgery is no longer is the absolute contraindication of lung metastatic carcinoma.Two kinds of advantages and disadvantages of each treatment for both the curative effect of malignant tumor with pulmonary nodules also confirmed there is no large amounts of data,some scholars put forward recently,evaluation criteria of tumor treatment is effective,not only depends on the survival of patients after treatment,also look at whether to alleviate the symptoms of the patients,improve the quality of life.Purpose:This study used questionnaires method to explore the psychological status of patients with malignant tumor combined with pulmonary nodules.To observe the short-term and long-term effects of chemotherapy and surgical treatment on anxiety and depression in patients.Combined with the literature,from the aspects of improving the quality of life of patients to explore the efficacy of the two treatment methods.Methods:40 cases of malignant tumor complicated with pulmonary nodules were selected from Shandong Qianfoshan Hospital from January 1,2014 to June 30,2016.22 cases were treated by surgery,and 18 cases chemotherapy.A total of 4 Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS)questionnaires were conducted in the two groups.The chest CT was examined every 3 months after treatment and followed up 6 months later.Four Anxiety and Depression Self-Rating Scales were carried out for each patient.The questionnaire was conducted before-and after treatment by the first Anxiety and Depression Self-Rating Scale.The surgery group was gi’ven 1 weeks,2 months and 4 months after treatment,and the chemotherapy group received 1 weeks,second cycles,fourth cycles and cycles after the end of the first cycle of chemotherapy.After the questionnaire was collected,the items were carefully checked,and the total scores of each questionnaire were accumulated,divided into sub-groups and averaged,and all the results were analyzed by SPSS 19.0 statistical software.Results:In this study,40 patients with malignant pulmonary nodules were divided into surgery group 22 cases and chemotherapy group 18 eases.The two groups before treatment had no difference in age,sex,SAS and SDS(P>0.05).Surgery group and chemotherapy group of patients with Self-Rating Anxiety Scale,Self-Rating Depression Scale scores were higher than the normal range(SAS>50,SDS>40),widely distributed in the moderate level of scores,and the scores in the two groups compared to the difference was no statistically significant difference(P>0.05).After treatment,in addition to first,the measurement operation group SAS,SDS scores were lower than the chemotherapy group(P<0.05).The surgery group of SAS,SDS in the second measurements score higher than before(P<0.05),score third times with preoperative and no differences(P>0.05),fourth SAS,SDS scores were significantly lower than that before operation(P<0.05).The chemotherapy group 3,4 measure SAS,SDS scores were higher than chemotherapy before(P<0.05),first times than the score after chemotherapy before chemotherapy is low,but the 3,4 score was higher than that before chemotherapy.At 6 months,two groups had no difference in the number of new nodules,deaths,and treatment(P>0,05)Conclusion:The anxiety and depression of the patients with malignant pulmonary nodules are moderate,compared with the chemotherapy group,the surgery group can obviously reduce the anxiety and depression of the patients,improve the quality of life of the patients,and will not affect the compliance of the patients,and the recurrence rate and mortality rate of the patients are lower.In conclusion,surgery can be considered more effective in improving mood and quality of life compared with chemotherapy in patients with malignant tumors combined with pulmonary nodules. |
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