CAJ | 학술논문

目的：探讨医护一体化护理对食管癌患者焦虑和抑郁负面情绪及免疫功能的影响。方法将符合条件的102例食管癌患者按随机数字表法分为医护一体化护理组52例和常规护理组50例。采用焦虑自评量表（SAS）和抑郁自评量表（SDS）评价2组患者手术前后的焦虑和抑郁不良情绪的分值，同时分别检测2组患者手术前后应激和免疫指标。结果2组患者术前焦虑、抑郁、应激反应及免疫指标比较差异无统计学意义，P>0．05。医护一体化护理组患者术后SAS、SDS评分明显低于常规护理组[（34.6±6.7）分比（44.8±7.5）分、（33.7±6.9）分比（40.6±7.3）分]，t=7.234、4.902，P<0.05，差异有统计学意义；常规护理组患者术后第8天的空腹血糖、C反应蛋白和血浆皮质醇水平明显高于医护一体化护理组[（6.98±1.12）mmol/L比（6.09±0.85）mmol/L、（18.11±5.93）mg/L比（9.24±3.22）mg/L、（293.98±69.09） nmol/L比（221.97±67.94）nmol/L ]，t=4.532、9.336、5.307，P<0．05，差异有统计学意义。术后第8天时，医护一体化护理组和常规护理组患者IgA、IgM均较术后第1天明显回升[（2.41±0.46）g/L比（1.89±0.56）g/L、（2.51±0.58）g/L比（1.35±0.67）g/L和（2.36±0.53）g/L比（1.82±0.46）g/L、（2.34±0.62）g/L比（1.37±0.64） g/L ]，t=5.174、9.439、5.549、7.850，P＜0.05，差异有统计学意义。医护一体化护理组患者血淋巴细胞总数和细胞因子（CD3、CD4、CD8、CD4/CD8）明显高于常规护理组[（2.87±0.65）×109/L比（1.98±0.58）×109/L、0.62±0.10比0.57±0.07、0.41±0.08比0.35±0.08、0.24±0.04比0.26±0.05、2.06±0.44比1.65±0.46]，t=7.286、2.915、3.787、2.225、4.601，P＜0.05，差异有统计学意义。结论医护一体化护理干预可以改善食管癌患者焦虑和抑郁负面情绪，降低应激反应，增强患者的免疫功能，利于患者康复。
목적：탐토의호일체화호리대식관암환자초필화억욱부면정서급면역공능적영향。방법장부합조건적102례식관암환자안수궤수자표법분위의호일체화호리조52례화상규호리조50례。채용초필자평량표（SAS）화억욱자평량표（SDS）평개2조환자수술전후적초필화억욱불량정서적분치，동시분별검측2조환자수술전후응격화면역지표。결과2조환자술전초필、억욱、응격반응급면역지표비교차이무통계학의의，P>0．05。의호일체화호리조환자술후SAS、SDS평분명현저우상규호리조[（34.6±6.7）분비（44.8±7.5）분、（33.7±6.9）분비（40.6±7.3）분]，t=7.234、4.902，P<0.05，차이유통계학의의；상규호리조환자술후제8천적공복혈당、C반응단백화혈장피질순수평명현고우의호일체화호리조[（6.98±1.12）mmol/L비（6.09±0.85）mmol/L、（18.11±5.93）mg/L비（9.24±3.22）mg/L、（293.98±69.09） nmol/L비（221.97±67.94）nmol/L ]，t=4.532、9.336、5.307，P<0．05，차이유통계학의의。술후제8천시，의호일체화호리조화상규호리조환자IgA、IgM균교술후제1천명현회승[（2.41±0.46）g/L비（1.89±0.56）g/L、（2.51±0.58）g/L비（1.35±0.67）g/L화（2.36±0.53）g/L비（1.82±0.46）g/L、（2.34±0.62）g/L비（1.37±0.64） g/L ]，t=5.174、9.439、5.549、7.850，P＜0.05，차이유통계학의의。의호일체화호리조환자혈림파세포총수화세포인자（CD3、CD4、CD8、CD4/CD8）명현고우상규호리조[（2.87±0.65）×109/L비（1.98±0.58）×109/L、0.62±0.10비0.57±0.07、0.41±0.08비0.35±0.08、0.24±0.04비0.26±0.05、2.06±0.44비1.65±0.46]，t=7.286、2.915、3.787、2.225、4.601，P＜0.05，차이유통계학의의。결론의호일체화호리간예가이개선식관암환자초필화억욱부면정서，강저응격반응，증강환자적면역공능，리우환자강복。
Objective To investigate the effect of all-in-one nursing intervention on esophageal carcinoma patients with bad emotion and immune function. Methods From the October, 2012 to the October, 2013, 102 patients with radical operation of esophageal carcinoma were divided into all-in-one nursing intervention group (research group, 52cases) and routine nursing group (control group, 50 cases) according to the random number table method.Two groups of patients were evaluated before and after operation of anxiety and depression emotion scores, with the Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) .At the same time, two groups of patients were detected the stress and immune index before and after the operation. Results Before operation, two groups of patients with anxiety, depression, stress reaction and immune index were not significantly different (P>0.05).After operation, the study group patients with anxiety and depression scores were significantly lower than those in the control group [(34.6+6.7) points vs. (44.8+7.5) points, (33.7+6.9) points vs. (40.6+7.3) points], the difference was statistically significant (t values were 7.234, 4.902, P<0.05). Eighth days after operation, patients in the control group FBG, CRP and Cor levels were significantly higher in the study group [(6.98±1.12)mmol/L vs.(6.09±0.85)mmol/L,(18.11±5.93) mg/L vs.(9.24±3.22)mg/L,(293.98±69.09)nmol/L vs.(221.97±67.94)nmol/L],the difference was statistically significant (t values were 4.532, 9.336, 5.307, P<0.05). Eighth days after operation, two groups of patients with IgA, IgM were higher than first days after operation [(2.41±0.46)g/L vs.(1.89±0.56)g/L,(2.51±0.58) g/L vs.(1.35±0.67)g/L and (2.36±0.53)g/L vs.(1.82±0.46)g/L, (2.34±0.62)g/L vs. (1.37±0.64) g/L], the difference was statistically significant (t values were 5.174, 9.439, 5.549, 7.850, P<0.05).The total number of patients blood lymphocytes (LYM) and cytokines (CD3, CD4, CD8, CD4/CD8) were significantly higher than the control group [(2.87±0.65)×109/L vs.(1.98±0.58)×109/L, 0.62±0.10 vs. 0.57±0.07, 0.41±0.08 vs. 0.35 ±0.08, 0.24 ±0.04 vs. 0.26 ±0.05, 2.06 ±0.44 vs. 1.65 ±0.46], the difference was statistically significant (t values were 7.286, 2.915, 6.942, 2.225, 4.601, P<0.05). Conclusion All-in-one nursing intervention can significantly improve the anxiety and depression in patients with esophageal cancer in bad mood, enhance the immune function of patients, conducive to the rehabilitation of patients.