心理干预疗法对围术期食管癌患者康复的影响  

Effects of psychological intervention on perioperative rehabilitation in patients with esophageal carcinoma

作　　者：陈冠璇[1] 张惠芳[2] 赵擎宇[1] 杨晓平[2] 邱云[2] 吴文杰[2] 

机构地区：[1]中山大学肿瘤防治中心重症监护室,华南肿瘤学国家重点实验室,广州510060 [2]中山大学中山医学院

出　　处：《中华全科医师杂志》2010年第3期169-172,共4页Chinese Journal of General Practitioners

基　　金：基金项目：国家教育部2007年大学生创新科研基金（62）

摘　　要：目的 评价心理干预对围术期食管癌患者康复的影响。方法选择中山大学附属肿瘤防治中心2008年1月至10月胸外科收治的60例食管癌患者，随机分为干预组（31例）、对照组（29例），采用症状自评量表SCL-90（symptomcheck list-90，SCL-90）对食管癌患者做心理状况评价，同时由经过培训并掌握一定肿瘤相关知识的医学生对于预组患者进行针对性心理干预，包括健康教育、心理支持、应激处理、应对技术与行为训练，分术前、术后第一疗程、术后第二疗程三个阶段进行，同时进行阶段性评价、分析。结果与1986年金华等发表的全国常模比较，手术前干预组和对照组的躯体化、强迫、抑郁、焦虑、偏执、敌对、恐怖7个因子分均较常模高（P〈0．05），两组间差异无统计学意义（P=0．31）。术后第4、24周，干预组的因子积分及其平均分逐渐下降，与对照组比较差异有统计学意义（t4=4．71，P4=0．002；t24=3．82，P24=0．005）。结论心理治疗对患者的心理状态产生积极作用，有利于患者术后康复。Objective To evaluate effects of psychological intervention on perioperative rehabilitation in patients with esophageal carcinoma. Methods Sixty patients with esophageal carcinoma hospitalized at thoracic surgery department of Sun Yat-sen University Cancer Center from January to October 2008 were randomly divided into intervention group （ IG, n = 31 ） and control group （ CG, n = 29）. The patients＇ psychological status was assessed with SCL-90 （symptom check list-90） scores. Psychological intervention was implemented by means of health education, psychological support, stress management, coping strategy and behavior training given by qualified medical interns in the University at three phases, i. e. , pre-operation, post-operation Ⅰand post-operation Ⅱ. Effects of intervention were evaluated in IG as compared with those in CG. Results Scores in domains of somatization, obsession, depression, anxiety, paranoia, hostility and phobbia were all higher in both IG and CG before surgical operation than those of national norm （P 〈 0. 05） set in 1986 by JIN Hua et al, but without significant difference between IG and CG （ P = 0. 31 ）. Scores of psychological factors in patients of IG demonstrated a steady decreasing tendency, which apparently differed from those of CG four and 24 weeks after surgical operation （ t4 = 4. 71, t4 = 0. 002 ; t24 = 3.82, P24 = 0. 005 ） , respectively. Conclusions Appropriate psychological intervention will help improve psychological status in patients with esophageal carcinoma and benefit their perioperative rehabilitation.

关 键 词：食管肿瘤 心理疗法 康复 

分 类 号：R735.1[医药卫生—肿瘤]