循S-ABC框架的系统心理干预措施对原发性肝癌患者围术期心理痛苦及免疫功能的影响  

Effects of Systematic Psychological Intervention Based on S-ABC Framework on Perioperative Psychological Distress and Immune Function in Patients with Primary Liver Cancer

作　　者：张英 杨凤霞 郭敬 张庆玲 ZHANG Ying;YANG Fengxia;GUO Jing;ZHANG Qingling(Dept.of Hepatobiliary Surgery,The 2nd Affiliated Hospital of Army Medical University,Chongqing 400037,China;Dept.of Medical Psychology,The 2nd Affiliated Hospital of Army Medical University,Chongqing 400037,China)

机构地区：[1]陆军军医大学第二附属医院肝胆外科,重庆400037 [2]陆军军医大学第二附属医院医学心理科,重庆400037

出　　处：《昆明医科大学学报》2023年第11期170-174,共5页Journal of Kunming Medical University

基　　金：重庆市科卫联合医学科研基金资助项目(2021MSXM133);陆军军医大学人文社科基金资助项目(2022XRW17)。

摘　　要：目的构建循S-ABC框架的系统心理干预措施,并探讨其对原发性肝癌患者围术期的心理痛苦及免疫功能的影响。方法组建医护管理团队,循证构建循S-ABC框架的系统心理干预措施。选择2021年1月至2022年5月收治入院的原发性肝癌患者76例,根据围手术期处理方法不同(肝动脉化疗栓塞术26例、腹腔镜肝切除30例、开腹肝切除20例),采用随机数字法分为对照组和实验组,每组38例。在整体护理的基础上,对照组给予常规心理指导,实验组给予循S-ABC框架的系统心理干预措施。比较2组患者在入院时、干预后1、3、6个月的心理痛苦程度及免疫功能状态。结果2组患者在入院时、干预后1、3、6个月的心理痛苦评分[实验组:(6.53±1.54)分、(3.66±1.12)分、(2.13±0.94)分、(0.87±0.70)分;对照组:(6.16±1.46)分、(4.45±1.11)分、(3.95±1.09)分、(2.26±0.86)分],入院时差异无统计学意义(P>0.05);干预后实验组心理痛苦评分下降更为明显,差异有统计学意义(P<0.05)。2组患者入院时、干预后1、3、6个月的免疫功能指标CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+),入院时各指标无统计学意义(P>0.05),实施干预措施后实验组患者各项指标明显优于对照组,差异有统计学意义(P<0.05)。结论循S-ABC框架的系统心理干预措施可有效减轻患者心理痛苦,提高机体免疫力,促进患者康复,是值得临床推广和借鉴的。Objective To establish a systematic psychological intervention based on S-ABC framework,and to explore its effects on perioperative psychological distress and immune function in patients with primary liver cancer.Methods A medical management team was established to construct systematic psychological intervention measures based on S-ABC framework.A total of 76 patients with primary liver cancer admitted from January 2021 to May 2022 were selected and divided into control group and experimental group by random number method according to different perioperative treatment methods(26 cases of hepatic arterial chemoembolization,30 cases of laparoscopic hepatectomy,20 cases of open hepatectomy),with 38 cases in each group.On the basis of finishing nursing,the control group was given routine psychological guidance,and the experimental group was given systematic psychological intervention measures based on the S-ABC framework.The degree of psychological distress and immune function were compared between the two groups at admission,1,3,and 6 months after intervention.Results The psychological pain scores of two groups of patients at admission and 1,3,and 6 months after intervention were[experimental group:(6.53±1.54)points,(3.66±1.12)points,(2.13±0.94)points,and(0.87±0.70)points;control group:(6.16±1.46)points,(4.45±1.11)points,(3.95±1.09)points,and(2.26±0.86)points],and showed no statistically significant difference in admission time(P>0.05);After intervention,the psychological pain score of the experimental group decreased significantly,and the difference was statistically significant(P<0.05).The immune function indicators of CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)at admission and 1,3,and 6 months after intervention had no statistically significant differences(P>0.05)between the two groups of patients.After implementing intervention measures,the experimental group of patients had significantly better indicators than the control group,with a statistically significant difference(P<0.05).Conclusion The systematic ps

关 键 词：原发性肝癌 循S-ABC框架 系统心理干预 心理痛苦 免疫功能 

分 类 号：R473[医药卫生—护理学]