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医护一体化护理对胃癌患者术后不良情绪和机体免疫的影响

朱光霞,陈惠   

  1. 上海交通大学医学院附属仁济医院南院 日间病房,上海交通大学医学院附属仁济医院南院 日间病房
  • 收稿日期:2017-07-02 修回日期:2017-08-23 出版日期:2017-10-25

Impact of Integrated Nursing Care on Postoperative Bad Emotion and Immune Function in Patients with Gastric Cancer

朱光霞 and Chen Hui   

  1. South Hospital Affiliated to Renji Hospital, Shanghai Jiaotong University,上海交通大学医学院附属仁济医院南院
  • Received:2017-07-02 Revised:2017-08-23 Online:2017-10-25

摘要: 目的:观察医护一体化护理对胃癌患者术后不良情绪和机体免疫的影响。方法:选择2014年1月至2016年12月在我院行胃癌根治术患者90例,按照随机数字法将患者分为观察组和对照组,每组各45例。对照组予以常规护理,观察组在对照组的基础上予以医护一体化护理。观察两组干预后留置导尿时间、肛门排气时间、胃肠减压时间、饮食时间和住院时间的变化及干预前后焦虑自评量表(SAS),抑郁自评量表(SDS),疲劳评分,自尊评分,IgA,IgG,IgM,淋巴细胞计数(LYM),CD3+,CD4+,CD8+和CD4+/CD8+水平的变化。结果:两组护理干预后,观察组的留置导尿时间、肛门排气时间、胃肠减压时间、饮食时间和住院时间明显短于对照组(P<0.01)。干预前两组SAS,SDS,疲劳评分,自尊评分,IgA,IgG,IgM,LYM,CD3+,CD4+,CD8+和CD4+/CD8+差异无统计学意义(P>0.05),干预后SAS,SDS,CD3+和CD8+较干预前明显降低(P<0.01),疲劳评分,自尊评分,IgA,IgG,IgM,LYM,CD4+和CD4+/CD8+明显高于干预前(P<0.01),观察组的降低或者升高的水平较对照组更为明显(P<0.01),CD3+,CD8+观察组与对照组的水平差异无统计学意义(P>0.05)。结论:医护一体化护理能够明显缩短胃癌患者术后康复时间,减少患者的不良情绪,减轻疲劳,提高自尊,与机体的免疫功能提高具有明显相关。

Abstract: Objective:To observe the impact of integrated nursing care on postoperative adverse emotions and immune function in patients with gastric cancer.Methods:90 patients with radical gastrectomy from January 2014 to December 2016 were divided into observation group and control group according to the random number method.The control group was treated with routine care. The observation group was treated with integrated nursing care on the basis of the control group. The levels of indwelling catheterization time,anal exhaust time,gastrointestinal decompression time,diet time and hospital stay were observed in two groups after nursing intervention, as well as the levels of self-rating depression(SAS),depression self-rating scale (SDS), fatigue score, self-esteem score, IgA, IgG, IgM, lymphocyte count (LYM), CD3+ , CD4+, CD8+ and CD4+/CD8+ cells.Results:After nursing intervention, the time of indwelling catheter, anal exhaust, decompression, diet and hospital stay were significantly shorter in observation group than those in control group (P<0.01).The levels of SAS, SDS, fatigue score, self-esteem score, IgA, IgG, IgM, LYM, CD3+ , CD4+, CD8+ and CD4+/CD8+ were not significantly different between two groups before nursing intervention. the levels of SAS, SDS, CD3+ and CD8+were significantly lower than those before nursing intervention (P<0.01), while the fatigue score, self-esteem score, IgA, IgG, IgM, LYM, CD4+and CD4+/CD8+ were significantly higher than those before nursing intervention (P<0.01). The decreasing and increasing levels were more obvious in observation group compared with control group (P<0.01). No significant differences of the levels of CD3+ , CD8+ between observation group and control group (P>0.05) were observed.Conclusion:The integrated nursing care significantly shortened the postoperative rehabilitation time reduced the negative emotions and fatigue, improved self esteem in patients with gastric cancer. The mechanism may be related to the increased immune function.