认知干预对经DC-CIK治疗的中晚期肝细胞癌患者生命质量、疼痛程度及临床疗效的影响  

Effect of Cognitive Intervention on Quality of Life,Pain Degree and Clinical Efficacy of Patients with Middle-advanced Hepatocellular Carcinoma by DC-CIK Therapy

作　　者：刘红梅[1] 宋宇[2] 杨月丽 穆岚[1] 钟鑫平[1] 

机构地区：[1]中国医科大学附属第一医院普通外科,沈阳110031 [2]武警辽宁省总队医院普通外科,沈阳110034

出　　处：《解放军医药杂志》2016年第5期48-53,共6页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：辽宁省科学技术计划项目(2011225019)

摘　　要：目的研究认知干预对经DC-CIK治疗的中晚期肝细胞癌患者的生命质量、疼痛程度及临床疗效的影响。方法选择中国医科大学附属第一医院普通外科及肿瘤内科2011年1月—2014年1月收治的中晚期肝细胞癌156例,随机分为观察组(82例)与对照组(74例)。两组均予肿瘤常规方案、DC-CIK方案治疗及常规心理干预,观察组同步予认知干预。治疗前后用肿瘤生命质量核心问卷(QLQ-C30)评估两组生命质量,采用视觉模拟评分法(VAS)评价两组疼痛程度,评估两组近、远期临床疗效,记录两组中位生存期,观察并记录治疗过程中的不良反应。结果治疗后两组QLQ-C30整体功能、特异性症状模块各指标及整体生命质量评分均明显优于治疗前(P<0.05,P<0.01),治疗后观察组上述指标均优于对照组(P<0.05);两组治疗后疼痛程度均明显低于治疗前(P<0.01),治疗后观察组疼痛程度明显低于对照组(P<0.05);治疗后两组近期临床疗效差异无统计学意义(P>0.05),观察组远期临床疗效优于对照组(P<0.05),且中位生存期长于对照组(P<0.05);两组治疗中主要不良反应发生率差异无统计学意义(P>0.05)。结论对于中晚期肝细胞癌患者在进行DC-CIK免疫治疗的基础上给予认知干预,能很好改善患者的生命质量、缓解疼痛、提高远期临床疗效,且安全性较高。Objective To investigate the effect of cognitive intervention on quality of life,pain degree and clinical efficacy of patients with middle-advanced hepatocellular carcinoma by dendritic cell-cytokine-induced killers cell（ DC-CIK） therapy.Methods A total of 156 patients with middle-advanced hepatocellular carcinoma admitted during January 2011 and January 2014 were randomly divided into observation group（ n = 82） and control group（ n = 74）.All patients were treated with routine chemotherapy,DC-CIK and routine mental intervention,and the observation group was added with cognitive intervention.In the two groups,quality of life was evaluated using Core quality of life questionnaire（ QLQ-C30） before and after the treatment;the pain degree was evaluated using visual analogue scales（ VAS）;short and long-term clinical efficacy was evaluated.The middle survival times were recorded,and adverse reactions during the therapy were also recorded in the two groups.Results After the treatment,the scores of QLQ-C30 allomeric function,specific symptom modules and the whole score of life quality were better,compared with those before treatment in the two groups（ P〈0.05,P〈0.01）,and the above scores in the observation group were better than those in the control group（ P〈0.05）;the pain degrees were milder,compared with those before the treatment in the two groups（ P〈0.01）,and the pain degree in the observation group was milder than that in the control group（ P〈0.05）.After the treatment,there was no significant difference in clinical efficacy in the two groups（ P〉0.05）;long-term clinical efficacy was significantly better（ P〈0.05）,and the mean times of survival was longer in observation group than those in the control group（ P〈0.05）.There was no significant difference in the incidence rate of adverse reactions in the two groups during the treatment（ P〈0.05）.Conclusion The cognitive intervention may well improve quality of life and long-term clinical efficacy,and safely

关 键 词：中晚期肝细胞癌 认知干预 树突状细胞-细胞因子诱导的杀伤细胞 治疗结果 生命质量 疼痛测定 

分 类 号：R735.7[医药卫生—肿瘤]