阶段性康复结合心理干预对胆囊癌患者预后及CYFRA21-1、sICAM-1的影响  

Effects of stage rehabilitation combined with psychological intervention on the prognosis and CYFRA21-1,sICAM-1 in patients with gallbladder cancer

作　　者：张星月 崔大鹏[1] 张鹏娟[1] 宋文丽[1] 张迎春[1] 刘振显[1] 连晶晶[1] 刘博[1] ZHANG Xingyue;CUI Dapeng;ZHANG Pengjuan(Department of Hepatobiliary Surgery,The First Hospital Affiliated to Hebei North College,Hebei,Zhangjiakou 075000,China)

机构地区：[1]河北北方学院附属第一医院肝胆外科,河北省张家口市075000

出　　处：《河北医药》2021年第7期1004-1008,共5页Hebei Medical Journal

基　　金：河北省医学科学研究重点课题(编号:20190915)。

摘　　要：目的探究并分析阶段性康复结合心理干预模式对胆囊癌患者术后恢复及血清细胞角蛋白21-1可溶性片段(CYFRA21-1)、血清细胞间粘附分子(sICAM-1)影响。方法选取2019年1月至2020年1月收治的胆囊癌患者63例,按照随机数字表法将其分为观察组(32例)和对照组(31例)。对照组患者采用阶段性康复干预,观察组实施阶段性康复联合心理干预模式。观察并记录2组患者一般资料(包括年龄、性别、体重、手术时间、术中出血等),手术前后SF-36生存质量评分,干预前后SAS评分(焦虑自评量表)和SDS评分(抑郁自评量表),治疗前后血清Cyfra21-1、sICAM-1水平,患者满意度等情况。结果2组患者手术前后生存质量评分比较差异有统计学意义(P<0.05),2组患者术前生存质量评分差异无统计学意义(P>0.05),术后2组患者生存质量评分均较术前显著改善(P<0.05),观察组术后1、2、3个月患者生存质量评分明显高于对照组(P<0.05);2组患者干预前SAS评分和SDS评分均差异无统计学意义(P>0.05),干预后2组患者SAS评分和SDS评分较前显著改善(P<0.05),观察组SAS评分和SDS评分显著低于对照组(P<0.05);经重复方差分析,2组患者治疗前后Cyfra21-1水平差异有统计学意义(P<0.05),治疗前2组患者Cyfra21-1水平差异无统计学意义(P>0.05),治疗后,2组患者Cyfra21-1水平均显著降低,治疗3个月后观察组患者Cyfra21-1水平显著低于对照组(P<0.05);2组患者治疗前后sICAM-1比较差有统计学意义(P<0.05),随着治疗的进行,2组患者sICAM-1水平逐渐降低,但观察组患者sICAM-1水平显著低于对照组(P<0.05);2组患者关爱以及主动服务满意度差异无统计学意义(P>0.05),观察组患者健康教育、心理支持、工作态度以及总体服务满意度明显高于对照组(P<0.05),差异有统计学意义。结论阶段性康复结合心理干预模式能有效降低胆囊癌患者炎性因子水平,改善患者心理状态,提高其生存质�Objective To investigate the effect of staged rehabilitation combined with psychological intervention on postoperative rehabilitation and serum levels of soluble fragment of cytokeratin 21-1(CYFRA21-1)and serum intercellular adhesion molecule 1(sICAM-1)in patients with gallbladder cancer.Methods A total of 63 patients with gallbladder cancer who were treated in our hospital from January 2019 to January 2020 were enrolled in the study,who were divided into observation group(n=32)and control group(n=31).The patients in control group were treated by stage rehabilitation intervention,however,the patients in observation group were treated with stage rehabilitation combined with psychological intervention.The general data including age,sex,weight,operation time,intraoperative hemorrhage were observed in both groups,moreover,,the SF-36 life quality score,SAS score(anxiety self-assessment scale)and SDS score(depression self-assessment scale)before and after intervention,and the serum levels of CYFRA21-1 and sICAM-1 as well as patient’s satisfaction degree were observed and compared between the two groups.Results After operation,the life quality scores in both groups were significantly improved(P<0.05),and the life quality scores at 1m,2m,3m after treatment in observation group were significantly higher than those in control group(P<0.05).After intervention the SAS scores and SDS scores in both groups were significantly improved,moreover,which in observation group were significantly lower than those in control group(P<0.05).After intervention,the CYFRA21-1 levels in both groups were significantly decreased,moreover,which in observation group at 3m after treatment were significantly lower than those in control group(P<0.05).With the progress of treatment,the sICAM-1 levels in both groups were gradually decreased,moreover,which in observation group were significantly lower than those in control group(P<0.05).In addition there were no significant differences in care and love as well as initiative service satisfaction degre

关 键 词：阶段性康复 心理干预 生存质量 胆囊癌 

分 类 号：R735.8[医药卫生—肿瘤]