Abstract: Objective To explore the current status of anxiety and depression among breast cancer surgery patients and their influencing factors, providing a basis for clinical diagnosis and treatment. Methods Patients who underwent surgical treatment in the Breast and Thyroid and Rectal Surgery Department of Chengde City Central Hospital from November 2022 to April 2024 were selected as the research subjects. They were divided into lumpectomy group （n=32） and mastectomy group （n=52） based on the surgical method. A longitudinal study was conducted using the Self-Rating Depression Scale （SDS） and Self-Rating Anxiety Scale （SAS） to assess the patients before surgery, three months after surgery, and six months after surgery. The general information and clinical characteristics of the patients were collected to analyze the occurrence of depression and anxiety among breast cancer surgery patients and their influencing factors. Results There was no significant difference in SAS and SDS scores between the two groups before surgery （P=0.770）. Three months after surgery, both groups showed a significant increase in SAS and SDS scores, with the lumpectomy group showing a more significant increase in anxiety scores （an increase of 7.6 points on average, P<0.001）, and the mastectomy group showing a more significant increase in depression scores （an increase of 7.2 points on average, P=0.010）. Six months after surgery, the anxiety and depression scores of the lumpectomy group returned to preoperative levels, while the depression scores of the mastectomy group were still higher than before surgery （P=0.048）, but there was no significant difference in depression scores between the two groups （P>0.05）. The analysis of the influencing factors on their psychological status showed that being young, having a low level of education, and having a low family monthly income were the main independent risk factors for anxiety and depression at all three time points （P<0.05）. Conclusion Breast cancer surgery patients have a high incidence of depression and anxiety, and the surgical method can directly affect patients′ depressive and anxious emotions. Compared to preoperative levels, anxiety increases more significantly in the lumpectomy group, and depression increases more significantly in the mastectomy group three months after surgery. Six months after surgery, the psychological state of the lumpectomy group recovers better, while the improvement in depression in the mastectomy group is relatively delayed. Medical staff should strengthen psychological care for breast cancer patients at all stages, especially three months after surgery. Different intervention strategies should be implantated for different groups to mitigate patients′ anxiety and depression.

Key words: breast cancer, depression, anxiety, influencing factors, surgical methods

摘要： 目的 探讨乳腺癌手术患者焦虑、抑郁状态现状及其影响因素,为临床诊治提供依据。方法 选取承德市中心医院甲乳直肠外科2022年11月~2024年4月住院并接受手术治疗的乳腺癌患者为研究对象,根据接受手术方式,分为保乳组（n=32）和全切组（n=52）,采用抑郁自评表（SDS）和焦虑自评表（SAS）对于手术患者在手术前,手术后3个月,手术后6月开展纵向研究,并收集患者一般资料及临床特征,分析乳腺癌手术患者中抑郁和焦虑情绪的发生情况及其影响因素。结果 术前两组间SAS和SDS评分无显著差异（P=0.770）。术后3个月,两组SAS、SDS评分均显著增加,保乳组焦虑评分增加更显著（均分增加7.6分,P<0.001）,全切组抑郁评分增加更显著（均分增加7.2分,P=0.010）。术后6月,保乳组焦虑和抑郁评分均恢复至术前水平,而全切组抑郁评分仍高于术前（P=0.048）,但两组间抑郁评分差异无统计学意义（P>0.05）。对其心理状况的影响因素分析结果显示：年龄小、文化程度低、家庭月收入低是患者三个时间段发生焦虑抑郁情绪的主要独立危险因素（P<0.05）。结论 乳腺癌手术患者抑郁、焦虑的发病率较高,手术方式能直接影响患者抑郁、焦虑情绪。对比术前,术后3月保乳组焦虑增加更显著,全切组抑郁增加更显著。术后6月,保乳组心理状态恢复较好,全切组抑郁改善相对滞后。医护人员应加强了解乳腺癌病人各阶段的心理状态,尤其是术后3月,针对不同的人群,应采取不同干预措施减轻病人的焦虑抑郁情绪,从而改善患者预后。

关键词: 乳腺癌, 焦虑, 抑郁, 影响因素, 手术方式