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患者在高热治疗过程中的心理和全身应激反应。

Psychological and systemic stress reactions of patients during hyperthermia treatments.

机构信息

Research Unit of Medical Engineering & Computing, Department of Surgery, Medical University of Graz, Austria.

出版信息

Int J Hyperthermia. 2009;25(6):488-97. doi: 10.1080/02656730903039613.

Abstract

PURPOSE

This study evaluated psychological stress reactions during hyperthermia (HT) treatments and compared them to systemic stress reactions.

MATERIALS AND METHODS

27 patients with malignant disease were treated with superficial or regional hyperthermia. Cortisol and the catecholamines adrenaline and noradrenaline in venous blood were used as markers of psychological stress. The anxiety proneness of the patients was evaluated with a trait-anxiety inventory. Blood pressure and heart rate were markers of systemic stress. Patients were first grouped by superficial or regional treatment and then into two subgroups: anxious and non-anxious patients.

RESULTS

The time course of the cortisol concentration of the superficial group showed a slight but significant decrease and that of the regional group an increase. The cortisol concentration of the regional group was sometimes slightly but significantly higher than in the superficial group, and in the group of anxious patients higher than in the group of non-anxious patients. The changes in time courses and differences in groups were not as pronounced for the catecholamine concentrations. Heart rate and blood pressure showed a significant increase only in the regional group, and there was no significant difference between the regional and the superficial groups. None of the variables showed a significant difference between the initial and the subsequent treatments; all lay well within the normal physiological range.

CONCLUSIONS

These standard hyperthermia treatments are not excessively stressful, either systemically or psychologically. The different behaviours of the variables confirm that it makes sense to consider systemic stress as well as psychological reactions.

摘要

目的

本研究评估了高热治疗期间的心理应激反应,并将其与全身应激反应进行了比较。

材料和方法

27 例恶性肿瘤患者接受了表浅或区域性高热治疗。采用静脉血皮质醇和儿茶酚胺肾上腺素和去甲肾上腺素作为心理应激的标志物。采用特质焦虑量表评估患者的焦虑倾向。血压和心率是全身应激的标志物。患者首先根据表浅或区域性治疗进行分组,然后分为两组:焦虑和非焦虑患者。

结果

表浅组的皮质醇浓度时间过程显示出轻微但显著的下降,而区域性组的皮质醇浓度则增加。区域性组的皮质醇浓度有时略高于表浅组,而在焦虑组中高于非焦虑组。儿茶酚胺浓度的时间过程变化和组间差异不那么明显。心率和血压仅在区域性组中显著增加,区域性组和表浅组之间无显著差异。所有变量在初始和后续治疗之间均无显著差异;均在正常生理范围内。

结论

这些标准的高热治疗既不会引起全身也不会引起心理过度应激。变量的不同行为证实,考虑全身应激和心理反应是有意义的。

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