心理干预对肺癌手术患者疼痛及免疫功能的影响

Influence of psychological intervention on pain and immune functions of patients receiving lung cancer surgery.

作者信息

Zhao Xinying, Cui Limin, Wang Wei, Su Quanzhi, Li Xiuzhi, Wu Junben

机构信息

Xinying Zhao, Binzhou People's Hospital, Shandong 256610, China.

Limin Cui, Binzhou People's Hospital, Shandong 256610, China.

出版信息

Pak J Med Sci. 2016 Jan-Feb;32(1):155-9. doi: 10.12669/pjms.321.8935.

DOI:10.12669/pjms.321.8935

PMID:27022366

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4794516/

Abstract

OBJECTIVE

To observe the influence of psychological intervention on pain, immune system and adrenocortical functions of patients receiving lung cancer surgery.

METHODS

We selected 124 patients who received surgery for treating stage I or II lung cancer and divided into experimental group and control group. The experimental group received comprehensive psychological intervention while the control group was given conventional nursing intervention. Pain of patients in two groups was evaluated by visual analog scale (VAS). Before and after intervention, CD3(+), CD4(+), CD8(+), CD4(+)/CD8(+) and free cortisol level in serum were measured. Moreover, QLQ-C30, a life quality measurement scale developed by European Organization for Research and Treatment of Cancer (EORTC) was used.

RESULTS

Compared to control group, VAS of patients in experimental group remarkably decreased before anesthesia, 6 hour, 12 hour 24 hour and 48 hour after surgery (P<0.05), and moreover, OLQ-C30 score and various factor scores (except physical symptoms) in experimental group were much higher (P<0.05). No statistical significant difference was found in immune index between two groups before intervention (P>0.05). Differences of CD3(+) and CD4(+) before and after intervention were both statistically significant (P<0.05), so did free cortisol level (P<0.05).

CONCLUSION

Comprehensive psychological intervention can effectively relieve pain, improve immune functions and enhance quality of life for patients suffering from lung cancer surgery.

摘要

目的

观察心理干预对肺癌手术患者疼痛、免疫系统及肾上腺皮质功能的影响。

方法

选取124例行Ⅰ期或Ⅱ期肺癌手术的患者，分为实验组和对照组。实验组接受综合心理干预，对照组给予常规护理干预。采用视觉模拟评分法（VAS）评估两组患者的疼痛程度。干预前后检测血清中CD3(+)、CD4(+)、CD8(+)、CD4(+)/CD8(+)及游离皮质醇水平。此外，使用欧洲癌症研究与治疗组织（EORTC）制定的生活质量测量量表QLQ-C30。

结果

与对照组相比，实验组患者在麻醉前、术后6小时、12小时、24小时及48小时的VAS评分显著降低（P<0.05），且实验组的QLQ-C30评分及各因子评分（除躯体症状外）均显著高于对照组（P<0.05）。干预前两组免疫指标差异无统计学意义（P>0.05）。干预前后CD3(+)和CD4(+)差异均有统计学意义（P<0.05），游离皮质醇水平差异亦有统计学意义（P<0.05）。