量化评估干预对乳腺癌手术患者应激反应的影响

The effect of quantitative evaluation intervention on the stress response in patients with breast cancer surgery

目的探讨量化评估干预对乳腺癌手术患者应激反应的影响。方法根据护理干预方法的不同将184例乳腺癌手术患者分为观察组和对照组,每组92例,观察组患者采取量化评估干预,对照组患者采取常规护理干预。记录并比较两组患者术前3天、术前30min、术毕及术后1天的心率、收缩压、舒张压、促肾上腺素皮质激素(ACTH)及皮质醇(Cor)水平,记录并比较两组患者术前3天、术前30min及术后1天的焦虑自评量表(SAS)和抑郁自评量表(SDS)评分。结果术前3天,两组患者的心率、收缩压、舒张压、ACTH水平、Cor水平、SAS评分及SDS评分比较,差异均无统计学意义(P﹥0.05)。术前30min和术毕,观察组患者的心率、收缩压、舒张压均低于对照组,差异均有统计学意义(P﹤0.05)。术前30min、术毕、术后1天,观察组患者的ACTH和Cor水平均低于对照组,差异均有统计学意义(P﹤0.05)。术前30min和术后1天,观察组患者的SAS和SDS评分均低于对照组,差异均有统计学意义(P﹤0.05)。结论与常规护理干预比较,量化评估干预可降低乳腺癌手术患者的心率、血压、ACTH及Cor水平,减轻患者的焦虑及抑郁情绪,从而减轻应激反应。

Objective To observe the effect of quantitative evaluation intervention on stress response in patients with breast cancer surgery.Method 184 patients with breast cancer were stratified as study group(n=92)and control group(n=92)according to different method of nursing care.The study group was given quantitative evaluation intervention and the control group was administered with conventional nursing care.The heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP),adrenocorticotropic hormone(ACTH)and cortisol(Cor)levels were recorded and compared between the two groups 3 days before surgery,30 minutes before surgery,at the end of surgery and 1 day after surgery.The self-rating anxiety scale(SAS)and self-rating depression scale(SDS)scores were compared between the two groups 3 days before surgery,30 minutes before surgery and 1 day after surgery.Result Three days before surgery,there were no significant differences in HR,SBP,DBP,ACTH and Cor levels and SAS and SDS scores between the two groups(P>0.05).At 30 minutes before surgery and at the end of surgery,the HR,SBP,and DBP were significantly lower in study group than in control group,the differences were of statistical significance(P<0.05).At 30 minutes before surgery,end of surgery and in 1 day after surgery,the ACTH and Cor levels were lower in study group compared to control group,with statistically significant difference noted(P<0.05).At 30 minutes before surgery and in 1 day after surgery,the SAS and SDS scores in study group were lower than those in control group,and the difference was also of statistical significance(P<0.05).Conclusion Quantitative evaluation intervention compared with conventional nursing care can reduce HR,blood pressure,ACTH and Cor level in patients with breast cancer surgery,alleviating anxiety and depression,thus reducing the stress response of patients.