儿童神经系统肿瘤放疗中临床辅助干预的疗效观察分析

Psychological intervention in alleviating anxiety for radiation treatment of pediatric central nervous system(CNS)tumor patients

目的心理干预手段下的儿童神经系统放疗目前在国内鲜有报道。本研究拟探索辅助心理干预手段对儿童神经系统肿瘤放疗的精神心理影响与疗效分析。方法纳入2016—2018年我院收治的90例神经系统肿瘤患儿作为研究对象,随机分成对照组和干预组(每组均45例),且两组患者各项指标均衡可比。对照组患儿不进行任何心理干预;若患儿不配合放疗,则直接行麻醉处理。干预组对患儿采用辅助心理干预措施。在心理干预无法确保患儿顺利进行放疗后,再行麻醉处理。观察两组患儿治疗前后SCL-90评分、SAS量表评分、心率、舒张压、收缩压、血糖、皮质醇及镇静药物和麻醉药物的使用情况。结果临床辅助干预组SCL-90评分中敌对、焦虑、恐惧治疗前后差值,显著高于对照组(P<0.05)。干预组患儿干预后SAS得分为(42.5±7.6)分,显著低于对照组(51.4±9.2)分(P<0.05)。干预组患儿在干预后2周、4周、6周的心率、舒张压、收缩压、血糖、皮质醇均显著低于对照组(P<0.05)。干预组患儿镇静药物和麻醉药物的使用率(26.7%)显著低于对照组(88.9%)(P<0.05)。结论临床辅助干预手段可以有效减低患儿在放疗过程中的心理行为应激,提高患儿放疗配合程度的同时降低麻醉镇静药物的使用率。

Objective To study the potential impacts of psychological intervention on anxiety relief of pediatric patients receiving radiotherapy.Methods Ninety children with brain tumors who admitted to our hospital from 2016 to 2018 were randomly divided into intervention group and control group,45 cases in each group.The indicators of the two groups were comparable.The control group was not given psychological intervention.Anesthesia were performed directly when the children in control group did not cooperate with radiotherapy.The intervention group was given psychological intervention on the basis of the control group.Anesthesia were performed after the psychological intervention was ineffective.SCL-90 score,SAS scale score,heart rate,diastolic pressure,systolic pressure,blood sugar,cortisol,and the rate of anesthetic use were observed before and after treatment.Results The difference of hostility,anxiety,and fear before and after treatment in SCL-90 score of intervention group was significantly higher than that of control group(P<0.05).After intervention,the SAS score of intervention group was 42.5+7.6,which was significantly lower than that of control group(51.4+9.2).The heart beats,diastolic blood pressure,systolic blood pressure,blood sugar and cortisol in the intervention group were significantly lower than those in the control group,at 2,4 and 6 weeks afterwards(P<0.05).In comparing to non-intervention group,the experimental group saw a clearly lower rate of anesthetic use(88.9%vs.26.7%,P<0.05).Conclusion Psychological intervention is found to significantly improve the anxiety and fear of children with brain tumors during radiation treatments,indicating more widely clinical use in the near future.