支持-表达性团体干预对行内镜黏膜下剥离术早期胃癌患者术前心理状态和治疗配合度的影响

Effect of support-expressive group intervention on preoperative psychological state and treatment compliance in patients with early gastric cancer under going endoscopic submucosal dissection

目的探讨支持-表达性团体干预对行内镜黏膜下剥离术(ESD)早期胃癌患者术前心理状态和治疗配合度的影响。方法将2019年9—12月入院给予常规干预的行ESD早期胃癌患者作为对照组(30例),2020年1—9月入院给予支持-表达性团体干预的患者作为观察组(30例)。采用症状自评量表(SCL-90)评估两组患者术前心理状态,采用视觉模拟评分法(VAS)评估疼痛程度,比较两组患者血清内皮素(ET)、一氧化氮(NO)、C反应蛋白(CRP)、白细胞介素-6(IL-6)、治疗配合度、康复效果和并发症发生情况。结果干预后,两组患者SCL-90量表各维度评分均降低,且观察组患者SCL-90量表各维度评分均低于对照组,差异均有统计学意义(P﹤0.05)。干预后1、3、7天,观察组患者VAS评分均明显低于对照组,差异均有统计学意义(P﹤0.01)。干预后,两组患者ET、NO、CRP、IL-6水平均升高,但观察组患者ET、NO、CRP、IL-6水平均低于对照组,差异均有统计学意义(P﹤0.05)。干预后,观察组患者手术配合、干预配合、用药配合、锻炼配合、饮食配合评分均明显高于对照组,差异均有统计学意义(P﹤0.01)。观察组患者胃肠动力恢复时间、下床活动时间、住院时间均明显短于对照组,差异均有统计学意义(P﹤0.01)。结论支持-表达性团体干预可明显缓解行ESD早期胃癌患者术前不良情绪,减轻患者术后疼痛程度和应激反应,且利于患者康复。

Objective To explore the effect of support-expressive group intervention on the preoperative psychological state and treatment compliance of patients with early gastric cancer undergoing endoscopic submucosal dissection(ESD).Method Patients with early gastric cancer who received conventional intervention from September to December 2019 and received the routine intervention were selected as the control group(30 cases),while patients admitted to the hospital from January to September 2020 and received supportive-expressive group intervention was set as the observation group(30 cases).The preoperative psychological state of the patients in the two groups was evaluated with the symptom checklist 90(SCL-90).The pain degree of patients was assessed by the visual analogue scale(VAS).The serum endothelin(ET),nitric oxide(NO),C-reactive protein(CRP),interleukin-6(IL-6),treatment compliance,rehabilitation effect,and complications in the two groups were also observed and compared.Result After the intervention,the scores of each dimension of the SCL-90 scale in the two groups decreased,and the above scores in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).One,three,and seven days after the intervention,the VAS scores of the observation group were significantly lower than those of the control group,and the differences were statistically significant(P<0.01).After the intervention,the levels of ET,NO,CRP,and IL-6 in the two groups were all increased,but these indexes in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After the intervention,the scores of operation cooperation,intervention cooperation,medication cooperation,exercise cooperation,and diet cooperation in the observation group were significantly higher than those in the control group,and the differences were statistically significant(P<0.01).The recovery time of gastrointestinal motility,time of getting out of bed,and hospital stay in the observation group were significantly shorter than those in the control group,and the differences were statistically significant(P<0.01).Conclusion The supportive-expressive group intervention could significantly relieve preoperative negative emotions of patients with early gas tric cancer undergoing ESD,reduce postoperative pain and stress response,and facilitate the recovery process.