快速康复外科对甲状腺癌患者围手术期心理状态和生活质量的影响

Effect of fast track surgery on perioperative psychological status and quality of life of patients with thyroid cancer

目的探讨快速康复外科(FTS)对甲状腺癌患者围手术期心理状态和生活质量的影响。方法依据围手术期干预方法的不同将150例甲状腺癌患者分为常规组和观察组,每组75例,常规组患者围手术期给予常规管理干预,观察组患者围手术期给予FTS管理。比较两组患者的手术相关指标、疼痛程度[视觉模拟评分法(VAS)]、心理状态[焦虑自评量表(SAS)和抑郁自评量表(SDS)]、生活质量[欧洲癌症研究与治疗组织生命质量测定量表(EORTC QLQ-C30)]和术后并发症发生情况。结果观察组患者术后下床时间、首次进流食时间、首次功能训练时间和住院时间均明显短于常规组,差异均有统计学意义(P﹤0.01)。术后12、24、48 h,观察组患者的VAS评分均明显低于常规组,差异均有统计学意义(P﹤0.01)。干预后,两组患者SAS、SDS评分均明显低于本组干预前,且观察组患者SAS、SDS评分均明显低于常规组,差异均有统计学意义(P﹤0.01)。干预后,两组患者躯体功能、角色功能、情绪功能、社会功能评分均明显高于本组干预前,且观察组患者躯体功能、角色功能、情绪功能、社会功能评分均明显高于常规组,差异均有统计学意义(P﹤0.01)。观察组患者的术后并发症总发生率为9.33%,明显低于常规组患者的34.67%,差异有统计学意义(P﹤0.01)。结论FTS能够促进甲状腺癌患者的术后恢复,改善患者围手术期心理状态和生活质量。

Objective To investigate the effect of fast track surgery(FTS)on perioperative psychological status and quality of life of patients with thyroid cancer.Method A total of 150 patients with thyroid cancer were divided into conventional group and observation group,75 cases in each group.The patients in the conventional group were given routine management intervention during the perioperative period,and the patients in the observation group were given FTS management during the perioperative period.The operation related indexes,pain degree[visual analogue scale(VAS)],psychological state[self-rating anxiety scale(SAS)and self-rating depression scale(SDS)],quality of life[European Organization for Research and Treatment of Cancer quality of life questionnaire core-30(EORTC QLQ-C30)]and postoperative complications were compared between the two groups.Result The time to first ambulation,first feeding and first function training and hospitalization time in observation group were lower than those in the conventional group(P<0.01).At12,24,48 hours after operation,the VAS scores of patients in the observation group were significantly lower than those in the conventional group,the differences were statistically significant(P<0.01).After intervention,the SAS and SDS scores of patients in the two groups were lower than those before the intervention,and the SAS and SDS scores of patients in the observation group were lower than those in the conventional group,the differences were statistically significant(P<0.01).After intervention,the scores of physical function,role function,emotional function and social function of patients in the two groups were significantly higher than those before the intervention,and the scores of physical function,role function,emotional function and social function of patients in the observation group were significantly higher than those in the conventional group,the differences were statistically significant(P<0.01).The total incidence of postoperative complications in the observation group was 9.33%,significantly lower than 34.67%in the conventional group(P<0.01).Conclusion FTS can promote the postoperative recovery of patients with thyroid cancer and improve their perioperative psychological status and quality of life.