综合护理措施对大肠癌患者术后免疫功能和心理状态的影响  

Effect of comprehensive nursing care on the postoperative immune function and psychological state of colorectal cancer patients

作　　者：朱桂玲[1] 高婧[1] 胡婧 马淑杰[1] 姜涛[1] ZHU Guiling;GAO Jing;HU Jing;MA Shujie;JIANG Tao(Department of Colorectal Surgery,the First Affiliated Hospital of Harbin Medical University,Harbin 150001,Heilongjiang,China)

机构地区：[1]哈尔滨医科大学附属第一医院结直肠外科,哈尔滨1500010

出　　处：《癌症进展》2018年第11期1435-1437,共3页Oncology Progress

基　　金：黑龙江省卫生厅科研课题(2009-081)

摘　　要：目的探讨综合护理措施对大肠癌患者术后免疫功能和心理状态的影响,从而建立一套系统的临床护理干预措施,指导临床治疗。方法选择接受手术治疗的120例大肠癌患者,依据随机数字表法将患者分为观察组和对照组,每组60例,观察组患者进行综合护理,对照组患者进行常规护理。采用抑郁自评量表(SDS)和焦虑自评量表(SAS)分析两组患者干预前和干预后的心理状态,采用流式细胞仪检测两组患者干预前和干预后的血清CD3^+、CD4^+、CD8^+T淋巴细胞水平。结果护理干预前,两组患者的CD3^+、CD4^+、CD8^+水平及CD4^+/CD8^+比较,差异均无统计学意义(P﹥0.05);护理干预后,观察组患者的CD3^+、CD4^+水平及CD4^+/CD8^+均高于对照组,CD8^+水平低于对照组,差异均有统计学意义(P﹤0.05)。护理干预前,两组患者的抑郁和焦虑评分比较,差异均无统计学意义(P﹥0.05);护理干预后,观察组患者的抑郁和焦虑评分均明显低于对照组,差异均有统计学意义(P﹤0.01)。结论结合心理干预的个体化综合护理能够显著改善大肠癌患者术后的心理健康状态,提高机体的免疫力,提升手术治疗效果,改善患者预后,对临床护理工作的开展具有重要意义。Objective To explore the effect of comprehensive nursing care on the postoperative immune function and psychological state of colorectal cancer patients, and to establish systematic interventions of nursing care to apply in clinical practice. Method A total of 120 cases of colorectal cancer patients receiving surgical treatment were included in the study and then randomized as study group and control group, with 60 cases in each. The patients in study group received comprehensive nursing care, while those in control group were given conventional nursing care. The psychological state before and after intervention of these patients were evaluated using self-rating depression scale（SDS） and self-rating anxiety scale（SAS）, besides, the serum CD3^＋, CD4^＋as well as CD8^＋T cells were measured by flow cytometry before and after intervention. Result Before nursing care, the CD3^＋, CD4^＋, CD8^＋and CD4^＋/CD8^＋levels were similar between the two groups（P〉0.05）; while after nursing care, the levels of CD3^＋, CD4^＋and CD4^＋/CD8^＋were higher, while CD8^＋level was lower in study group than in control group, with statistically significant difference observed（P〈0.05）. Before nursing care, the scores of depression and anxiety in the two groups showed no significant difference（P〉0.05）; while after nursing care, they were lower in study group compared with control group, indicating statistically significant difference（P〈0.01）. Conclusion Comprehensive individual nursing care in combination with psychological intervention is helpful to improve the postoperative psychological health of colorectal cancer patients, and enhance immune function as well as surgical effect, ameliorating prognosis, meanwhile facilitating practical nursing care.

关 键 词：大肠癌 个体化综合护理 免疫功能 

分 类 号：R735.34[医药卫生—肿瘤]