肝癌患者术前焦虑对T细胞亚群的影响及护理干预效果评价

Study for the effect on preoperative anxiety to T-cell subsets and evaluation on nursing Intervention for patient with liver cancer

目的探讨不同干预措施对减轻原发性肝癌患者术前焦虑的效果及临床护理干预措施。方法采用焦虑自评量表（SAS）对2006年7月~2008年9月我院肝癌住院病人进行评估，筛选出焦虑患者128例（A组），在非焦虑病人中随机抽取126例作为对照（B组），应用SPSS软件产生随机分组序列号法将A、B组分为心理干预加药物、心理干预、药物干预、未干预4个亚组。比较各组术后第7天、第14天SAS分值及T细胞亚群。结果焦虑组（A组）T细胞亚群低于非焦虑组B组（P〈0．05），焦虑组中心理干预加药物及心理干预组在术后第7天、第14天SAS分值及T细胞亚群恢复优于单纯药物干预组及未干预组（P〈0．05）；非焦虑组心理加药物、心理干预组在术后第7天、第14天SAS分值及T细胞亚群差异无显著意义（P〉0．05）。结论肝癌患者术前焦虑可引起机体细胞免疫抑制，心理加药物干预及心理干预可减轻患者焦虑情绪，促进术后细胞免疫恢复。

Objective To study the effect on different interventions for reducing preoperative anxiety for patients with liver cancer and to find out the better nursing intervention. Method 132 patients with anxiety were selected and divided as anxiety group （A group）, meanwhile 132 patients without anxiety were selected as control group （B group）. The patients with liver cancer using self-rating anxiety scale（SAS）, and Then the A group and B group were divided into four subgroups including psychological plus drug intervention group, psychological intervention group, drug intervention group and no intervention group. The SAS score and T-cell subsets were estimated and compare 7th and 14th after operation among groups. Result T-cell subsets in anxiety group was significantly lower than that of no anxiety group（P〈0.05）. The SAS score and T cell subset of psychological plus drug intervention and psychological intervention 7th and 14th after operation in anxiety group was significantly better than that of single drug intervention （P〈0.05）. There was no significant difference in no anxiety group by different intervention （P〉0.05）. Conclusion Preoperative anxiety of patients with liver cancer can induce body cell Immune suppression. The postoperative cell immune recovery would be achieved by psychological plus drug intervention and psychological intervention, patients anxiety will be reduced also.