| 张 薛,黄媛媛,陆炳燕,张成伟,林 琳.认知行为疗法对腹腔镜肾癌根治术患者应激反应、心理弹性及免疫功能的影响[J].,2024,(5):868-872 |
| 认知行为疗法对腹腔镜肾癌根治术患者应激反应、心理弹性及免疫功能的影响 |
| Effects of Cognitive Behavioral Therapy on Stress Response, Psychological Resilience and Immune Function in Patients Undergoing Laparoscopic Radical Nephrectomy |
| 投稿时间：2023-09-04 修订日期：2023-09-26 |
| DOI：10.13241/j.cnki.pmb.2024.05.011 |
| 中文关键词: 认知行为疗法 腹腔镜肾癌根治术 应激反应 心理弹性 免疫功能 |
| 英文关键词: Cognitive behavioral therapy Laparoscopic radical nephrectomy Stress reaction Psychological resilience Immune function |
| 基金项目:国家自然科学基金项目（81902581） |
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| 中文摘要: |
| 摘要 目的：探讨认知行为疗法对腹腔镜肾癌根治术患者给应激反应、心理弹性及免疫功能的影响，为改善腹腔镜肾癌根治术患者康复效果提供参考依据。方法：按抛掷硬币法将2019年1月-2022年12月南京鼓楼医院收治的80例腹腔镜肾癌根治术患者随机分为对照组和观察组，对照组40例患者行常规干预，观察组40例患者行认知行为疗法干预。比较两组患者临床基本指标、应激反应、心理弹性、免疫功能及生活质量等指标变化情况。结果：干预后，观察组排气时间、尿管留置时间、下床活动时间以住院时间均短于于对照组（P＜0.05）。两组干预后皮质醇、肾上腺素水平与心理弹性评分均较干预前升高（P＜0.05），且观察组皮质醇、肾上腺素水平低于对照组，心理弹性评分高于对照组（P＜0.05）。两组干预后CD3+、CD4+及CD4+/CD8+水平较干预前升高，CD8+水平较干预前降低（P＜0.05）；且观察组CD3+、CD4+及CD4+/CD8+水平高于对照组，CD8+水平低于对照组（P＜0.05）。两组干预后生活质量各项评分均高于干预前（P＜0.05），且观察组高于对照组（P＜0.05）。结论：认知行为疗法干预腹腔镜肾癌根治术患者不仅可有效改善患者负性情绪，提升其心里弹性，还可降低患者应激反应，提高机体免疫功能，加快其术后康复进程，值得临床借鉴应用。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the effect of cognitive behavioral therapy on stress response, psychological elasticity and immune function in patients undergoing laparoscopic radical nephrectomy, and to provide reference for improving the rehabilitation effect of patients undergoing laparoscopic radical nephrectomy. Methods: According to the coin toss method, 80 patients with laparoscopic radical nephrectomy admitted to Nanjing Drum Tower Hospital from January 2019 to December 2022 were randomly divided into control group and observation group. 40 patients in the control group received routine intervention, and 40 patients in the observation group received cognitive behavioral therapy intervention. The changes of clinical basic indexes, stress response, psychological elasticity, immune function and quality of life were compared between the two groups. Results: After intervention, the exhaust time, catheter indwelling time, off-bed activity time and hospitalization time in the observation group were shorter than those in the control group (P<0.05 ). After intervention, the levels of cortisol and epinephrine and the scores of psychological resilience in the two groups were higher than those before intervention (P<0.05 ), and the levels of cortisol and epinephrine in the observation group were lower than those in the control group, and the scores of psychological resilience were higher than those in the control group(P<0.05). After intervention, the levels of CD3+, CD4+ and CD4+/ CD8+ in the two groups were higher than those before intervention, and the level of CD8+ was lower than that before intervention (P<0.05 ). The levels of CD3+, CD4+ and CD4+/ CD8+ in the observation group were higher than those in the control group, and the level of CD8+ was lower than that in the control group (P<0.05). The scores of quality of life in the two groups after intervention were higher than those before intervention (P<0.05), and those in the observation group were higher than the control group (P<0.05). Conclusion: The intervention of cognitive behavioral therapy in patients undergoing laparoscopic radical nephrectomy can not only effectively improve the negative emotions of patients, improve their mental elasticity, but also reduce the stress response of patients, improve the immune function of the body, and accelerate the postoperative rehabilitation process, which is worthy of clinical reference and application. |
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