心理干预在胃癌根治术患者中的应用

Application of Mental Intervention in Patients with Radical Gastrectomy

目的:探讨心理干预在胃癌根治术患者中的应用效果。方法:将2011年9月~2015年3月行胃癌根治术的150例患者随机分为对照组和观察组各75例。对照组实施围术期常规护理,观察组在对照组基础上加强心理干预。比较两组焦虑自评量表(SAS)、抑郁自评量表(SDS)、匹茨堡睡眠质量指数量表(PSQI)、健康调查简表(SF-36)评分及患者术后恢复情况、并发症发生情况。结果:出院前1 d,观察组SAS、SDS、PSQI评分均低于对照组(P<0.05);SF-36评分中,除生理机能外,观察组其他7个维度得分均高于对照组(P<0.05);观察组术后肛门排气时间、排便时间、进食时间、肠鸣音恢复时间、首次下床时间及住院时间均短于对照组(P<0.05);观察组并发症发生率低于对照组(P<0.05);随访2年,观察组复发率低于对照组(P<0.05)。结论:给予胃癌根治术患者围术期心理干预,可缓解患者焦虑、抑郁情绪,改善睡眠质量,减轻心理负担,利于患者恢复,能够降低并发症发生率及复发率。

Objective： To explore the application effect of psychological intervention in patients with radical gastrectomy. Methods： A total of 150 patients who underwent radical gastrectomy from September 2011 to March 2015 were randomly divided into control group and observation group,75 cases in each group. The control group received routine nursing during the perioperative period,and the observation group strengthened psychological intervention on the basis of the control group. The two groups of anxiety self rating scale（ SAS）,self rating Depression Scale（ SDS）,Pittsburgh sleep quality index（ PSQI）,health survey（ SF-36）,postoperative recovery and complications were compared. Results： The scores of SAS,SDS and PSQI in the observation group were lower than those in the control group at one day before discharge（ P〈0. 05）. In addition to physiological functions,the scores of the other 7 dimensions in the observation group were higher than those in the control group（ P〈0. 05）; postoperative anal exhaust time,defecation time,eating time,recovery time of bowel sounds,first time to get out of bed and hospital stay were shorter in the observation group than in the control group（ P〈0. 05）; the incidence of complications in the observation group was lower than that in the observation group（ P〈0. 05）; After 2 years of follow-up,the recurrence rate of the observation group was lower than that of the control group（ P〈0. 05）. Conclusion： Perioperative psychological intervention in patients undergoing radical gastrectomy can alleviate anxiety and depression,improve sleep quality,reduce psychological burden,facilitate patient recovery,and reduce the incidence of complications and recurrence rate.