稳定化技术对食管癌患者围手术期心理应激干预效果观察

Intervention effect of stabilizing technique on mental stress in esophageal carcinoma patients during perioperation

目的评价稳定化技术对食管癌患者围手术期心理应激的干预效果。方法随机选择2011年5月-2012年5月我院食管鳞状细胞癌住院患者67例,随机分为常规组32例和干预组35例,另选65名健康者作为健康对照组。健康对照组仅做心理状况评估,常规组接受手术治疗和常规护理,干预组在常规组治疗方案基础上采用稳定化技术进行围手术期心理干预。结果抑郁、焦虑评分食管癌组均高于健康对照组(12.481±3.312 vs 4.040±1.332,22.623±7.670 vs 6.285±1.741),干预组术后比常规组明显下降(5.16±1.66 vs 9.68±2.72,9.61±2.70 vs 15.78±4.41),干预组术后比术前明显下降(5.16±1.66vs 12.72±3.53,9.61±2.70 vs 23.82±7.81)。睡眠质量评分食管癌组高于健康对照组(7.58±1.78 vs 3.67±5.39),手术后干预组比常规组明显下降(3.94±3.34 vs 6.44±1.69)。手术后干预组使用止痛剂时间、自行排痰时间、卧床时间、住院时间均显著少于常规组(P<0.05),食欲、疼痛、家庭理解与配合和疾病认识评分均显著高于常规组(P<0.05)。结论稳定化技术可以改善患者的心理应激状况和手术后康复状况,改善手术后生活质量。

Objective To assess the intervention effect of stabilizing technique on mental stress in esophageal carcinoma patients during perioperation.Methods Sixty-seven patients with pathology-confirmed esophageal squamous cell carcinoma admitted to our hospital from May 2011 to May 2012 were randomly divided into control group（n=32） and intervention group（n=35）.Another 65 healthy persons served as a control group.Mental condition in control group was assessed.Subjects in control group received surgical treatment and routine care.Patients in intervention group received mental intervention of stabilizing technique during perioperation in addition to the treatment in control group.Results The average depression and anxiety scores were significantly higher in intervention group than in control group（22.623±7.670 vs 6.285±1.741,12.481±3.312 vs 4.040±1.332）.The average depression and anxiety scores were significantly lower in intervention group than in control group after operation（5.16±1.66 vs 9.68±2.72,9.61±2.70 vs 15.78±4.41）.The depression and anxiety scores were significantly lower in intervention group after operation than before operation（5.16±1.66 vs 12.72±3.53,9.61±2.70 vs 23.82±7.81）.The sleep quality score was significantly higher in intervention group than in control group（7.58±1.78 vs 3.67±5.39） and was significantly lower in intervention group than in control group after operation（3.94±3.34 vs 6.44±1.69）.Except for＂use of hypnotics＂ and ＂daytime dysfunction＂,the other sleep quality factors showed a significant difference（P 0.05）.The analgesics use time,self-expectoration time,bed time and hospital stay time were significantly shorter whereas the scores of appetite,pain,family understanding and cooperation and disease were significantly higher in intervention group than in control group after operation（P 0.05）.Conclusion Stabilizing technique can improve the postoperative mental stress,rehabilitation and quality of life of esophageal carcinoma patients.