肌肉放松训练联合正念减压疗法在肝门部胆管癌根治性切除术患者围手术期的应用  

Application of progressive muscle relaxation training combined with mindfulness-based stress reduction therapy in perioperative period of patients with radical resection of hilar cholangiocarcinoma

作　　者：殷蓉 徐莎莎 何超 朱海欧 李相成 YIN Rong;XU Shasha;HE Chao;ZHU Haiou;LI Xiangcheng(Hepatobiliary Center,the First Affiliated Hospital of Nanjing Medical University,Jiangsu Province,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院肝胆中心,江苏南京210029

出　　处：《中国医药导报》2024年第1期163-167,共5页China Medical Herald

基　　金：国家自然科学基金资助项目(82273066)。

摘　　要：目的探究肝门部胆管癌(HCCA)患者根治性切除术围手术期行渐进性肌肉放松训练(PMRT)联合正念减压疗法(MBSR)干预的效果。方法前瞻性选取2020年5月至2022年5月南京医科大学第一附属医院收治的接受根治性切除术的HCCA患者120例,根据随机数字表法分为对照组(围手术期给予常规干预联合PMRT干预)60例和观察组(围手术期常规干预基础上给予PMRT联合MBSR干预)60例,两组均干预5周。采用汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)和Herth希望量表评价两组干预前后心理状态和希望水平,比较两组干预前后免疫功能指标及并发症发生情况。结果干预后,两组HAMA、HAMD评分低于干预前,且观察组低于对照组,差异有统计学意义(P<0.05)。干预后,两组与他人保持的亲密关系、采取的积极行动、对现实和未来的积极态度及总量表评分高于干预前,且观察组高于对照组,差异有统计学意义(P<0.05)。干预后,两组CD3+、CD4+、CD4+/CD8+高于干预前,且观察组高于对照组,差异有统计学意义(P<0.05);干预后,两组CD8+低于干预前,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论PMRT联合MBSR用于HCCA患者根治性切除术围手术期具有重要的临床价值。Objective To investigate the effect of progressive muscle relaxation training(PMRT)combined with mindfulnessbased stress reduction(MBSR)in patientswith hilar cholangiocarcinoma(HCCA)after radical resection.Methods A total of 120 patients with HCCA who underwent radical resection in the First Affiliated Hospital of Nanjing Medical University from May 2020 to May 2022 were prospectively selected.According to the random number table method,a total of 60 cases were divided into the control group(routine intervention combined with PMRT intervention in perioperative period)and the observation group(PMRT combined with MBSR intervention on the basis of routine intervention in perioperative period).The intervention lasted for five weeks in both groups.Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD),and Herth hope scale were used to evaluate the psychological state and hope level of the two groups before and after intervention,and the immune function indexes and complications were compared between the two groups before and after intervention.Results After intervention,HAMA and HAMD scores of the two groups were lower than those before intervention,and those of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).After intervention,the close relationship maintained with others,positive actions taken,positive attitude towards reality and future,and total scale score of the two groups were higher than those of before intervention,while those of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).After intervention,CD3+,CD4+,and CD4+/CD8+in both groups were higher than those before intervention,and those of observation group were higher than those of control group,and the differences were statistically significant(P<0.05).After intervention,CD8+in both groups were lower than those of before intervention,and those of those of the observation group were lower than those of t

关 键 词：肝门部胆管癌 根治性切除术 渐进性肌肉放松训练 正念减压疗法 

分 类 号：R473.73[医药卫生—护理学]