目的

探讨乳腺癌患者乳房重建手术前后的心身症状及干预治疗的效果。

方法

采用焦虑自评量表（self-rating anxiety scale，SAS）和抑郁自评量表（selfrating depression scale，SDS）对天津医科大学附属肿瘤医院乳腺一科2001年5月至2007年2月96例乳腺癌术后患者在乳房重建手术前后心身症状进行评价，同时在重建手术前后对患者进行心理干预治疗，评价治疗效果。

结果

心理干预治疗降低了乳房重建术前焦虑、抑郁、自卑、躯体症状及外形不满意的发生率（P＜0.05），而对性吸引力下降无改善（P＞0.05）。乳房重建术后心身症状发生率在干预治疗后低于心理干预治疗前（P＜0.05）。心理干预治疗显著降低腹直肌皮瓣重建术后心身症状发生率（P＜0.05），而对背阔肌皮瓣重建后可降低焦虑、抑郁及躯体症状发生率（P＜0.05），同时降低假体重建术后焦虑抑郁发生率（P＜0.05），而对其它症状无改善（P＞0.05）。

结论

心理干预治疗降低了乳房重建手术前后乳腺癌患者心身症状的发生率，对提高乳腺癌患者的生活质量有积极作用。

Objective

To study the psychological and physical symptoms after postmastectomy breast reconstruction and the effect of psychological interference for breast cancer patients.

Methods

From May 2001 to February 2006，96 breast cancer patients in our hospital received mastectomy and immediate breast reconstruction.All patients were given psychological interference before and after operation.After operation，self-rating anxiety scale and self-rating depression scale were used to test the psychological and physical symptoms of the patients，and the effect of psychological interference treatment was analyzed.

Results

Before breast reconstruction psychological disturb treatment decreased the incidence of psychological physical symptom（P＜0.05）but the incidence of sexual appeal decreasing didn't change.After breast reconstruction，the incidence of psychological-physical symptom of post-psychological disturb treatment is lower than that of pre-psychological disturb treatment（P＜0.05）.Psychological disturb treatmen decrease obviously the incidence of psychological physical symptom in the TRAM group（P＜0.05），the incidence of anxiety，distress and body symptom in the LDM group（P＜0.05），and the incidence of anxiety and distress in the implant group（P＜0.05），but without any effection on other symptom（P＞0.05）.

Conclusions

Psychological interference treatment can decrease psychological-physical symptoms in breast reconstruction patients. Breast reconstruction combined with psychological interference is beneficial and also increases the life quality for breast cancer patients.