疼痛干预联合Snyder希望理论对肝癌患者经导管动脉栓塞化疗后睡眠质量及希望水平的影响

Effects of pain intervention combined with Snyder’s hope theory on sleep quality and hope level in patients with liver cancer after transcatheter arterial chemoembolization

目的探讨疼痛干预联合Snyder希望理论对肝癌患者经导管动脉栓塞化疗(TACE)后睡眠质量及希望水平的影响。方法将88例接受TACE治疗的肝癌患者根据干预方式的不同分为对照组(42例,采用常规术后干预)和联合组(46例,采用疼痛干预联合Snyder希望理论干预)。比较两组患者的睡眠质量[匹兹堡睡眠质量指数(PSQI)和睡眠状况自评量表(SRSS)]、希望水平[Herth希望指数(HHI)]、自我感受负担[自我感受负担量表(SPBS)]、疼痛情况[视觉模拟评分法(VAS)评分、镇痛药物使用量]、炎症因子[C反应蛋白(CRP)、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)]、肝功能指标[天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)和总胆红素(TBIL)]及不良反应发生情况。结果干预后,两组患者SRSS、PSQI评分均较干预前降低,且联合组患者SRSS、PSQI评分均低于对照组,差异均有统计学意义(P﹤0.05)。干预后,两组患者对现实和未来的积极看法、行动倾向以及与他人的关系亲密度评分均较干预前升高,且联合组患者对现实和未来的积极看法、行动倾向以及与他人的关系亲密度评分均高于对照组,差异均有统计学意义(P﹤0.05)。干预后,两组患者身体负担、情感负担、经济负担评分均较干预前降低,且联合组患者身体负担、情感负担、经济负担评分均低于对照组,差异均有统计学意义(P﹤0.05)。干预后,两组患者CRP、IL-6、TNF-α、ALT、AST、TBIL水平均较干预前降低,且联合组患者CRP、IL-6、TNF-α、ALT、AST、TBIL水平均低于对照组,差异均有统计学意义(P﹤0.05)。干预后,联合组患者VAS评分和镇痛药物使用量均低于对照组,差异均有统计学意义(P﹤0.05)。联合组患者恶心、呕吐、疲劳发生率均低于对照组,差异均有统计学意义(P﹤0.05)。结论疼痛干预联合Snyder希望理论能显著改善肝癌患者TACE术后的睡眠质量、希望水平,缓解术后疼痛,降低炎症因子水平,改善肝功能,提升患者的总体康复效果。

Objective To investigate the effects of pain intervention combined with Snyder’s hope theory on sleep quality and hope level in patients with liver cancer after transcatheter arterial chemoembolization(TACE).Method A total of 88 patients with liver cancer who received TACE were divided into control group(42 cases,conventional postoperative intervention)and combination group(46 cases,pain intervention combined with Snyder’s hope theory intervention)according to different intervention methods.The sleep quality[Pittsburgh sleep quality index(PSQI)and self-rating scale of sleep(SRSS)],hope level[Herth hope index(HHI)],self-perceived burden[self-perceived burden scale(SPBS)],pain status[visual analogue scale(VAS)score,analgesic drug usage],inflammatory factors[C-reactive protein(CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)],liver function indicators[aspartate aminotransferase(AST),alanine aminotransferase(ALT)and total bilirubin(TBIL)]and the occurrence of adverse reactions were compared between the two groups.Result After intervention,the SRSS and PSQI scores in two groups were lower than those before intervention,and the SRSS and PSQI scores in combination group were lower than those in control group,the differences were statistically significant(P<0.05).After the intervention,the scores of positive views on reality and future,the tendency to act and intimacy with others in both groups were higher than those before intervention,and the scores of positive views on reality and future,the tendency to act and intimacy with others in the combination group were higher than those in the control group,the differences were statistically significant(P<0.05).After intervention,the scores of physical burden,emotional burden and economic burden in two groups were lower than those before intervention,and the scores of physical burden,emotional burden and economic burden in the combination group were lower than those in the control group,the differences were statistically significant(P<0.05).After intervention,the levels of CRP,IL-6,TNF-α,ALT,AST and TBIL in two groups were lower than those before intervention,and the levels of CRP,IL-6,TNF-α,ALT,AST and TBIL in combination group were lower than those in control group,the differences were statistically significant(P<0.05).After intervention,the VAS score and analgesic drug usage in combination group were lower than those in control group,the differences were statistically significant(P<0.05).The incidences of nausea,vomiting and fatigue in combination group were lower than those in control group,and the differences were statistically significant(P<0.05).Conclusion Pain intervention combined with Snyder’s hope theory can significantly improve the sleep quality and hope level of liver cancer patients after TACE surgery,relieve postoperative pain,reduce the level of inflammatory factors,improve liver function,and enhance the overall rehabilitation effect of patients.