加速康复外科干预对脑胶质瘤患者应激反应、心理状态及生活质量的影响

Effect of accelerated rehabilitation surgical intervention on stress response,psychological status and quality of life in patients with glioma

目的探讨加速康复外科干预对脑胶质瘤患者应激反应、心理状态及生活质量的影响。方法根据干预方式的不同将310例脑胶质瘤手术患者分为对照组(n=155)和观察组(n=155),对照组患者予以常规干预,观察组患者在对照组的基础上联合加速康复外科干预。比较两组患者的手术相关指标、应激反应指标[白细胞介素-6(IL-6)和皮质醇(Cor)]、心理状态[抑郁自评量表(SDS)和焦虑自评量表(SAS)]及生活质量[欧洲癌症研究与治疗组织生命质量测定量表(EORTC QLQ-C30)]。结果观察组患者的术后恢复进食时间、首次下床活动时间、尿管拔除时间及术后住院时间均明显短于对照组,差异均有统计学意义(P<0.01);两组患者的手术时间、术中出血量比较,差异均无统计学意义(P﹥0.05)。术后3天,两组患者的血清IL-6、Cor水平均高于本组术前,观察组患者的血清IL-6、Cor水平均低于对照组,差异均有统计学意义(P<0.05)。干预后,两组患者的SDS、SAS评分均低于本组干预前,观察组患者的SDS、SAS评分均低于对照组,差异均有统计学意义(P<0.05)。干预后,两组患者的躯体功能、情绪功能、社会功能、认知功能、角色功能评分均高于本组干预前,观察组患者的躯体功能、情绪功能、社会功能、认知功能、角色功能评分均高于对照组,差异均有统计学意义(P<0.05)。结论加速康复外科干预可缩短脑胶质瘤手术患者的住院时间,减轻应激反应,促进患者术后恢复,改善患者负性情绪,提高患者生活质量。

objective To investigate the effect of accelerated rehabilitation surgical intervention on stress response,psychological status and quality of life in patients with glioma.Method A total of 310 glioma patients treated by surgery were divided into the control group(n=155,received routine intervention)and observation group(n=155,received routine intervention and accelerated rehabilitation surgical intervention).The surgery-related indicators,stress response indicators[interleukin-6(IL-6)and cortisol(Cor)],psychological status[self-rating depression scale(SDS)and self-rating anxiety scale(SAS)]and quality of life[European Organization for Research and Treatment of Cancer quality of life questionnaire core 30(EORTC QLQ-C30)]were compared between the two groups.Result The time to resume eating after surgery,the time to first ambulation,the time of catheter removal and the postoperative hospital stay in the observation group were shorter than those in the control group(P<0.01).There were no significant differences in operation time and intraoperative blood loss between the two groups(P>0.05).Three days after surgery,the serum levels of IL-6 and Cor in the two groups were higher than those before surgery,with lower levels in the observation group than those in the control group(P<0.05).After intervention,the SDS and SAS scores of the two groups were lower than those before intervention,and the SDS and SAS scores in the observation group were lower than those in the control group(P<0.05).After intervention,the scores of physical function,emotional function,social function,cognitive function and role function of the two groups were higher than those before intervention,with higher scores in the observation group than those in the control group(P<0.05).Conclusion The accelerated rehabilitation surgical intervention can shorten the hospital stay,relieve the stress response,promote the postoperative recovery,and improve the negative emotions and the quality of life in patients with glioma.