鼻咽癌病人同步放化疗前后身心适应状况及其相关因素  

Physical and mental adaption status of patients with nasopharyngeal carcinoma before and after concurrent chemoradiotherapy and its related factors

作　　者：柯熹[1] 骆惠玉[1] 陈秀梅[1] 蒋梦媛[1] 林丽[1] 黄丽洁[1] 刘雅清[1] 杨华清[1] 

机构地区：[1]福建医科大学教学医院福建省肿瘤医院(福建卫生职业技术学院护理系)

出　　处：《护理研究（上旬版）》2016年第7期2343-2348,共6页Chinese Nursing Researsh

基　　金：福建省自然科学基金计划项目;编号:2013J01287;国家临床重点专科建设项目(国卫办医函〔2013〕544号)

摘　　要：[目的]调查鼻咽癌同步放化疗病人治疗前后心理适应及T淋巴细胞功能水平,分析心理适应水平与T淋巴细胞功能的相关性,为临床心理护理工作提供依据。[方法]采用方便抽样的方法,收集2013年10月—2015年4月入住我院放疗科符合纳入及排除标准且接受同步放化疗的鼻咽癌病人126例,在治疗前、后分别使用一般资料调查表、简明癌症病人心理适应问卷(Mini-MAC-19)、症状自评量表(SCL-90)进行调查,并于治疗前、后在无菌技术操作下取病人外周抗凝血2mL,使用流式细胞仪测定CD__3、CD_4及CD_8免疫指标,分析心理适应状况与免疫指标的相关性。[结果]鼻咽癌病人同步放化疗前不同年龄段病人的心理适应评分不同,不同收入水平病人CD_3、CD_4指标不同,差异均具有统计学意义(P均<0.05);同步放化疗后不同婚姻状况病人SCL-90评分不同,不同婚姻状况病人CD_4、CD_8指标不同,造瘘病人SCL-90评分明显低于未行胃造瘘病人,差异均具有统计学意义(P均<0.05);同步放化疗病人治疗前、后SCL-90评分及CD_3、CD_4指标存在差异(P均<0.05);同步放化疗后心理适应总分与CD_3免疫指标呈正相关(P<0.05)。[结论]鼻咽癌同步放化疗病人治疗前应关注不同年龄段、文化程度病人及收入水平者的身心适应情况,治疗后应关注不同婚姻状况病人;同步放化疗对病人身心适应状况有明显的影响,病人治疗后心理适应状况较好者具有较强的T淋巴细胞免疫功能。Objective：To investigate the psychological adaptation and T lymphocyte function level in patients with nasopharyngeal carcinoma receiving concurrent chemoradiotherapy before and after treatment ,and to ana-lyze the correlation between level of psychological adaptation and function of T lymphocytes ,in order to provide basis for clinical psychological nursing work .Methods ：A convenient sampling method was adopted to collect a total of 126 cases of nasopharyngeal carcinoma patients admitted to our hospital from October 2013 to April 2015 ,w ho met the inclusion and exclusion criteria and received the concurrent radiotherapy and chemotherapy . They were investigated by General Information Questionnaire ,Simple Cancer Patient Psychological Adaptation Questionnaire（Mini MAC 19） and Symptom Self Rating Scale（SCL 90） before and after treatment .At the same time ,before and after treatment ,the anti coagulation peripheral blood 2 ml was taken with aseptic tech-nique operation ,the CD3 ,CD4 and CD8 were measured by flow cytometry ,and correlation between psychological adaptation and immune parameters was analyzed .Results：Before concurrent chemoradiotherapy ,different ages of patients with nasopharyngeal carcinoma had different levels of psychological adaptation score ,and different in-come levels of patients had different CD3 and CD4 indicators ,there were statistically significant difference （both P〈0 .05）;after concurrent chemoradiotherapy ,SCL 90 score of patients with different marital status was dif-ferent ;different marital status of patients had different CD4 and CD8 indicators ,SCL 90 score was significantly lower than that of patients without gastric stoma in the patients with fistula ,and there were statistically signifi-cant difference（P〈0 .05）;before and after treatment ,the SCL 90 score and CD3 and CD4 were different（P〈0 .05） . The total score of psychological adaptation was positively correlated with CD 3 （P〈0 .05） .Conclusion：The phys-ical and psychological adaptati

关 键 词：鼻咽癌 放射治疗 化学治疗 心理行为 T淋巴细胞亚群 

分 类 号：R473.73[医药卫生—护理学]