社会心理因素对子宫内膜癌患者腹腔镜手术后应激状态的影响

Effect of social psychological factors on postoperative stress in patients with endometrial cancer undergoing laparoscopic surgery

目的探讨社会心理因素对子宫内膜癌患者腹腔镜手术后应激状态的影响。方法选取2015年8月至2016年4月间武汉大学中南医院收治的行腹腔镜手术的84例子宫内膜癌患者,采用随机数字表法分为观察组与对照组,每组42例。观察组患者针对社会心理因素进行相应护理,对照组患者采用常规护理,比较两组患者术后的应激状态和应对方式。结果观察组患者术后1d的焦虑评分为(9.25±2.35)分,低于对照组患者的(12.23±3.05)分,观察组患者的皮质醇和肾上腺素水平分别为(120.36±4.27)ng/L和(130.26±11.26)ng/L,低于对照组患者的(132.56±14.21)ng/L和(154.20±20.39)ng/L,组间比较差异均有统计学意义(均P<0.05)。观察组患者术后1d的疼痛评分、回避评分和屈服评分分别为(2.21±0.57)分、(51.24±8.79)分和(50.23±6.76)分,低于对照组患者的(4.52±0.67)分、(82.37±12.58)分和(65.23±12.09)分;观察组患者术后1d的面对评分为(84.57±5.41)分,高于对照组患者的(74.34±5.30)分,组间比较,差异均有统计学意义(均P<0.05)。结论社会心理因素护理能够减轻子宫内膜癌患者腹腔镜手术后的应激反应,改善患者的应对方式,减轻疼痛。

Objective To investigate the effect of psychosocial factors i on postoperative stress in patients with endometrial cancer undergoing laparoscopic surgery. Methods Select 84 patients with endom- etrial cancer undergoing laparoscopic surgery at Zhongnan Hospital of Wuhan University from August 2015 to April 2016. Patients were divided into an observation group and a control group by random number table method, with 42 patients in each group. The observation group was given social-psychological factors targe- ted nursing and the control group was given routine nursing. The stress level and coping strategies were com- pared between the two groups. Results The anxiety score at 1 d after the surgery was 9. 25 ± 2. 35 in the observation group, which was lower than 12. 23 ± 3.05 of the control group. Cortisol and epinephrineleverls were lower in the observation group （ 120. 36 ±4. 27 ng/L and 130. 26 ± 11.26 ng/L, respectively） than in the control group （ 132. 56 ± 14. 21 ng/L and 154. 20 ± 20. 39 ng/L, respectively） （ P 〉 0.05 ）. Pain, a- voidance and yield scores in the observation group （2. 21 ±0. 57, 51.24 ±8.79 and 50.23 ±6. 76, respec- tively） were lower than in the control group （4. 52 ±0. 67, 82. 37 ± 12. 58 and 65.23 ± 12. 09, respective- ly）. The acceptance score was higher in the observation group （84. 57 ± 5.41 ） than in the control group （74. 34 ± 5.30） （ all P 〉 0. 05 ）. Conclusion Social psychological nursing can reduce the stress reaction, improve the coping strategies and relieve pain in patients with endometrial cancer.