综合护理干预对宫颈癌患者心理及免疫力影响研究

Effects of integrated care intervention on psychology and immunity of patients with cervical cancer

摘要:

目的：观察综合护理干预对宫颈癌（cervical cancer，CC）患者术后心理及相关免疫指标的影响，从而建立起一套系统的临床护理干预措施，指导临床实践。方法：选取本院自2009年5月-2012年2月诊治的128例ＣＣ患者，按入院先后采用随机数字表法分入心理干预组（观察组）和常规护理组（对照组），分析患者术后的心理特点和相关免疫指标，比较两种护理方法的效果。结果：观察组干预后术前抑郁自评量表（self-rating depression scale，SDS）、焦虑自评量表（self-rating anxiety scale，SAS）得分均显著降低（抑郁t=6.821，P＝0.00０；焦虑t=4.803，P＝0.00０），对照组分值改变不明显（抑郁t=1.570，P=0.146；焦虑t=0.939，P=0.382），干预后观察组２项得分均低于对照组（抑郁t=5.415，P＝0.00０；焦虑t=4.299，P＝0.00０）；２组患者干预后T淋巴细胞亚群CD3+、CD4+、CD8+及CD4+/CD8+比值均得到不同程度的改善，但观察组患者要优于对照组（t=7.959，P＝0.00０；t=2.543，P=0.015；t=2.983，P=0.004；t=2.778，P＝0.007；t=5.479，P＝0.00０）。结论：结合心理干预的临床综合护理能够显著改善ＣＣ患者术后心理健康水平，提高机体免疫力，提升手术治疗效果，改善患者的预后，对临床护理工作开展具有重要的意义。

Abstract:

Objective：To observe the effects of integrated care intervention on psychology and immunity of patients with cervical can－cer（CC） in order to establish a clinical interventions system to guide nursing care. Methods：Totally 128 patients with CC were select－ed from May 2009 to February 2012 in our hospital and were divided into psychological intervention group（observation group） and usual care group（control group）. Postoperative psychological characteristics and associated immune indicators of patients were ana－lyzed. Results：After the intervention，self-rating depression scale（SDS） and self-rating anxiety scale（SAS） scores of observation group were significantly lower （SDS：t=6.821，P=0.000；SAS：t=4.803，P=0.000） and those of control group remained the same（SDS：t=1.570，P=0.146；SAS：t=0.939，P=0.382）. Two scores in observation group were significantly lower than those in control group（SDS：t=5.415，P=0.000；SAS：t=4.299，P=0.000）. T lymphocyte subsets CD3+，CD4+，CD8+ and CD4+/CD8+ ratio were improved at varying de－grees in both groups，but the effects were significantly better in observation group than in control group（t=7.959，P=0.000；t=2.543，P=0.015；t=2.983，P=0.004；t=2.778，P=0.007；t=5.479，P=0.000）. Conclusions：Clinical care combined with psychological intervention can significantly improve mental health and immunity，enhance treatment outcome，promote prognosis for patients with CC，besides，it is important for clinical nursing care.