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目的探讨不同干预措施对原发性肝癌焦虑患者术后免疫功能的影响。方法采用焦虑自评量表(SAS)对所有肝癌住院病人进行评估,筛选出焦虑组(A组)132例,在非焦虑病人中选择与焦虑组相匹配的132例作为对照组(B组)。按照随机数字表法再将A、B组分别分为心理干预+药物干预、心理干预、药物干预和未干预等4个亚组。比较A、B组术前及各亚组术前、术后1、4、7、14、30d免疫抑酸性蛋白(IAP)和IL-6的水平。结果焦虑组术前IAP和IL-6的水平明显高于非焦虑组,差异有统计学意义(P<0.01);术后焦虑各亚组中,心理干预+药物干预、心理干预组在术后第1、4、7、14、30天患者IAP和IL-6的水平低于单纯药物干预组及未干预组(P<0.05、P<0.01);术后非焦虑各亚组IAP和IL-6的水平差异无统计学意义(P>0.05)。结论肝癌患者术前焦虑直接参与机体免疫功能的抑制,并与手术打击存在协同抑制机体免疫功能,心理干预+药物干预及单纯心理干预均能调节患者术后机体免疫功能,促进疾病康复。
Objective To investigate the effects of different interventions on postoperative immune function in patients with primary liver cancer with anxiety. Methods A total of 132 inpatients with hepatocellular carcinoma (HCC) were screened by anxiety self-rating scale (SAS). 132 patients in anxiety group (A group) were screened out and 132 patients in anxiety group were selected as control group (B group) . A and B groups were divided into four subgroups: psychological intervention + drug intervention, psychological intervention, drug intervention and non-intervention according to the random number table method. The levels of immunosuppressive protein (IAP) and IL-6 at preoperative and postoperative day 1, 4, 7, 14 and 30 were compared before and after operation in groups A and B. Results The levels of preoperative IAP and IL-6 in anxiety group were significantly higher than those in non-anxiety group (P <0.01). Psychological intervention + medication intervention and psychological intervention group were significantly different The levels of IAP and IL-6 in patients on the 1st, 4th, 7th, 14th and 30th day were lower than those in the simple drug intervention group and the non-intervention group (P <0.05, P <0.01) 6 levels were not statistically different (P> 0.05). Conclusions The preoperative anxiety of HCC patients is directly involved in the inhibition of immune function, and synergistically inhibits the immune function with the surgery. Psychological intervention + drug intervention and psychological intervention can both regulate the postoperative immune function and promote the recovery of the disease.