心理支持及认知干预在腹膜后恶性肿瘤患儿围手术期应用的研究  

The application of psychological support and cognitive intervention in the perioperative period of children with retroperitoneal malignant tumor

作　　者：祁文清 陈依君[2] 陈凯 QI Wenqing;CHEN Yijun;CHEN Kai(Operating Room, Xinhua Hospital Affiliated Shanghai Jiaotong University School of Medicine, Shanghai 200092, China;Anesthesia and Intensive Care Medicine, Xinhua Hospital Affiliated Shanghai Jiaotong University School of Medicine, Shanghai 200092, China;Pediatric Surgery, Xinhua Hospital Affiliated Shanghai Jiaotong University School of Medicine, Shanghai 200092, China)

机构地区：[1]上海交通大学医学院附属新华医院手术室,上海200092 [2]上海交通大学医学院附属新华医院麻醉与重症医学科,上海200092 [3]上海交通大学医学院附属新华医院小儿外科,上海200092

出　　处：《癌症进展》2019年第4期490-493,共4页Oncology Progress

摘　　要：目的探讨心理支持及认知干预在腹膜后恶性肿瘤患儿围手术期应用的价值。方法回顾性分析70例接受腹膜后恶性肿瘤切除术患儿的临床资料。根据围手术期干预方法不同,分为观察组(常规护理干预+心理支持及认知干预)35例和对照组(常规护理干预)35例。比较两组患儿围手术期的生活质量、转化生长因子-β(TGF-β)水平、CD4+/CD8+值及术后并发症的发生情况。结果入院时,两组患儿的生理功能、情感功能、社会功能、角色功能评分及总分比较,差异均无统计学意义(P﹥0.05);术后28天,观察组患儿的生理功能、情感功能、社会功能、角色功能评分及总分均明显高于对照组,差异均有统计学意义(P﹤0.01)。入院时,两组患儿的TGF-β水平、CD4+/CD8+值比较,差异均无统计学意义(P﹥0.05);与入院时比较,术前及术后1、28天,两组患儿的TGF-β水平均呈下降趋势;与入院时比较,术前两组患儿的CD4+/CD8+值均略升高,术后1天均略降低,术后28天均明显升高;术后28天,观察组患儿的TGF-β水平为(132.5±46.5)ng/ml,低于对照组的(166.8±49.8)ng/ml,差异有统计学意义(P﹤0.05);术后28天,观察组患儿的CD4+/CD8+值为(1.49±0.47),高于对照组的(1.23±0.38),差异有统计学意义(P﹤0.05)。两组患儿术后并发症的总发生率比较,差异无统计学意义(P﹥0.05)。结论腹膜后恶性肿瘤患儿围手术期接受心理支持及认知干预,可以改善免疫功能,提高生活质量。Objective To explore the value of applying psychological support and cognitive intervention during the perioperative period for children with retroperitoneal malignant tumor. Method The retrospective analysis included the clinical data of 70 cases of children with retroperitoneal malignant tumor, who were stratified as study group and control group, receiving conventional nursing care plus psychological support and cognitive intervention, or conventional nursing care alone, respectively, with 35 cases in each. The perioperative quality of life, transforming growth factor-β(TGF-β), CD4^+/CD8^+ value and occurrence of postoperative complications of these children were compared. Result When admitted to hospital, there were no significant differences in the physiological function, emotional function, social function, role function and overall rating scores between the two groups (P>0.05);in 28 days after surgery, the physiological function, emotional function, social function, role function and overall rating scores of study group were higher than those of control group, demonstrating statistically significant differences (P<0.01). When admitted to hospital, the two groups of children had similar level of TGF-β and CD4^+/CD8^+ value (P>0.05);before surgery and on 1^st and 28th day after surgery, the TGF-β level in both groups showed decreasing trend compared with that at the time of admission;CD4^+/CD8^+ slightly increased while modestly reduced on 1st day after surgery, and exhibited significant increase in 28 days after surgery compared with that at the time of admission;in 28 days after surgery, the TGF-β in study group was (132.5±46.5) ng/ml, which was lower than the (166.8±49.8) ng/ml in control group, with statistically significant difference observed (P<0.05);during the same period, the CD4^+/CD8^+ value was (1.49±0.47) in study group, and was higher than that in control group at (1.23±0.38), indicating statistical significance (P<0.05). There was no significant difference in regard of the incidence o

关 键 词：护理 腹膜后肿瘤 心理干预 认知 

分 类 号：R735.4[医药卫生—肿瘤]