摘要
目的分析多学科团队管理干预在胃癌患者内镜黏膜下剥离术围手术期中的应用效果。方法将93例行内镜黏膜下剥离术的早期胃癌患者按照干预方式的不同分为对照组(n=46,常规干预)和观察组(n=47,多学科团队管理干预)。比较两组患者恢复情况、不良情绪[汉密尔顿抑郁评分(HAMD)、汉密尔顿焦虑评分(HAMA)]、生活质量[诺丁汉健康量表(NHP)]、炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)]、并发症发生情况。结果观察组患者术后进食时间、术后肛门排便时间、住院时间均明显短于对照组,差异均有统计学意义(P﹤0.01)。干预后,两组患者HAMA、HAMD量表评分均较干预前降低,且观察组患者HAMA、HAMD量表评分均低于对照组,差异均有统计学意义(P﹤0.05)。干预后,两组患者情感职能、躯体活动、疼痛评分均较干预前降低,且观察组患者情感职能、躯体活动、疼痛评分均低于对照组,差异均有统计学意义(P﹤0.05)。术后5天,两组患者TNF-α、IL-6、IL-10水平均较术后1天降低,且观察组患者TNF-α、IL-6、IL-10水平均低于对照组,差异均有统计学意义(P﹤0.05)。观察组患者并发症总发生率低于对照组患者,差异有统计学意义(P﹤0.05)。结论早期胃癌内镜黏膜下剥离术患者围手术期采取多学科团队管理干预效果确切,可有效减轻患者负性心理,提高患者的生活质量,降低并发症发生率,促进患者恢复,值得临床进一步研究并实施。
Objective To analyze the effect of multidisciplinary team management intervention on the perioperative period of endoscopic submucosal dissection of patients with gastric cancer.Method A total of 93 patients with early gastric cancer who underwent endoscopic submucosal dissection were divided into control group(n=46,received routine intervention)and observation group(n=47,received multidisciplinary team management intervention)according to different intervention methods.The recovery,adverse emotion[Hamilton depression scale(HAMD),Hamilton anxiety scale(HAMA)],quality of life[Nottingham health profile(NHP)],inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-10(IL-10)]and the incidence of complications in the two groups were compared.Result The postoperative feeding time,postoperative anal defecation time and hospital stay in the observation group were shorter than those in the control group(P<0.01).After intervention,HAMD and HAMA scores in the two group were decreased than those before intervention,with lower scores in the observation group than those in the control group(P<0.05).After intervention,the emotional function,physical activity and pain score of the two groups were decreased after intervention than those before intervention,with lower scores in the observation group than those in the control group(P<0.05).Five days after surgery,the levels of TNF-α,IL-6 and IL-10 in both groups were decreased than those before the one day after surgery,with lower levels in the observation group than those in the control group(P<0.05).The complication rate in the observation group was significantly lower than that in the control group(P<0.05).Conclusion Multidisciplinary team management intervention in the perioperative period of endoscopic submucosal dissection of patients with early gastric cancer is effective,which can effectively regulate adverse emotion,improve the quality of life,reduce the occurrence of complications,promote the recovery of patients,which is worthy of further c
作者
朱英
王卉
黄潇
ZHU Ying;WANG Hui;HUANG Xiao(Endoscopy Center,Zhumadian Central Hospital,Zhumadian 463000,He’nan,China)
出处
《癌症进展》
2023年第16期1818-1821,共4页
Oncology Progress
关键词
多学科团队管理干预
内镜黏膜下剥离术
胃癌
生活质量
multidisciplinary team management intervention
endoscopic submucosal dissection
gastric cancer
quality of life
