针对性康复干预对晚期胰腺癌患者血清炎性因子及免疫功能水平的影响
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摘要
目的探究针对性康复干预对晚期胰腺癌患者血清炎性因子及免疫功能水平的影响。方法晚期胰腺癌患者64例采用随机数字表法将其分为常规组的康复组,每组32例。常规组使用常规放化疗治疗及相应干预、护理模式;康复组在其基础上根据患者具体情况为其制定针对性康复干预方案,使用焦虑自评量表(SAS)、抑郁自评量表(SDS)、评估患者心理状态,记录并分析2组炎性因子[白介素-6(IL-6)、白介素-10(IL-10)、肿瘤坏死因子α(TNF-α)]、免疫功能水平(IgA、IgG、IgM、CD~+_3、CD~+_4、CD~+_4/CD~+_3)。结果干预前2组SAS、SDS评分及血清炎性因子、免疫功能指标水平差异无统计学意义(P>0.05),干预后,康复组SAS、SDS评分显著低于常规组(P<0.05),2组炎性因子水平均上升,免疫功能指标水平均下降,康复组血清炎性因子水平显著低于常规组,体液免疫功能指标及细胞功能免疫指标水平显著高于常规组,差异均有统计学意义(P<0.05)。结论对晚期胰腺癌患者施加针对性康复干预能有效缓解患者不良情绪,键入癌症及放化疗对其免疫功能的影响,降低患者血清炎性因子水平,值得临床推广。
Objective To explore the effect of targeted rehabilitation intervention on serum inflammatory factors and immune function in patients with advanced pancreatic cancer.Methods A total of 64 patients with advanced pancreatic cancer who were admitted and treated in our hospital from November 2015 to November 2018 were divided into the routine treatment group(n=32) and rehabilitation treatment group(n=32) according to the random number table. The patients in routine group were treated by conventional chemoradiotherapy and related interventions, nursing model,however,the patients in rehabilitation treatment group,on the basis of routine treatment group, were treated by the targeted rehabilitation intervention program according to the specific circumstances of patients. The self-rating anxiety scale(SAS), self-evaluation depression scale(SDS) were used to evaluate the patient's psychological state. The inflammatory factors(IL-6, IL-10, TNF-α) and the levels of immune function(IgA, IgG, IgM, CD~3_+, CD■, CD■/CD~3_+) were observed and compared between the two groups.Results Before intervention there were no significant differences in the scores of SAS and SDS, serum inflammatory factors, and immune function levels between the two groups(P>0.05). After intervention, the scores of SAS and SDS in rehabilitation treatment group were significantly lower than those in routine treatment group(P<0.05), moreover the levels of inflammatory factors in both groups were significantly increased, as compared with those before intervention, however the levels of immune function in both groups were significantly decreased.In addition the serum levels of inflammatory factors in rehabilitation treatment group were significantly lower than those in routine treatment group, but the indexes of humoral immune function and the levels of cell function immune function in rehabilitation treatment group were significantly higher than those in routine treatment group(P<0.05).Conclusion The targeted rehabilitation intervention for patients with advanced pancreatic cancer can effectively alleviate the bad emotions of patients, improve the influence of chemoradiotherapy on immune function of patients, and reduce the levels of serum inflammatory factors,thus, which is worthy of clinical promotion.
Objective To explore the effect of targeted rehabilitation intervention on serum inflammatory factors and immune function in patients with advanced pancreatic cancer.Methods A total of 64 patients with advanced pancreatic cancer who were admitted and treated in our hospital from November 2015 to November 2018 were divided into the routine treatment group(n=32) and rehabilitation treatment group(n=32) according to the random number table. The patients in routine group were treated by conventional chemoradiotherapy and related interventions, nursing model,however,the patients in rehabilitation treatment group,on the basis of routine treatment group, were treated by the targeted rehabilitation intervention program according to the specific circumstances of patients. The self-rating anxiety scale(SAS), self-evaluation depression scale(SDS) were used to evaluate the patient's psychological state. The inflammatory factors(IL-6, IL-10, TNF-α) and the levels of immune function(IgA, IgG, IgM, CD~3_+, CD■, CD■/CD~3_+) were observed and compared between the two groups.Results Before intervention there were no significant differences in the scores of SAS and SDS, serum inflammatory factors, and immune function levels between the two groups(P>0.05). After intervention, the scores of SAS and SDS in rehabilitation treatment group were significantly lower than those in routine treatment group(P<0.05), moreover the levels of inflammatory factors in both groups were significantly increased, as compared with those before intervention, however the levels of immune function in both groups were significantly decreased.In addition the serum levels of inflammatory factors in rehabilitation treatment group were significantly lower than those in routine treatment group, but the indexes of humoral immune function and the levels of cell function immune function in rehabilitation treatment group were significantly higher than those in routine treatment group(P<0.05).Conclusion The targeted rehabilitation intervention for patients with advanced pancreatic cancer can effectively alleviate the bad emotions of patients, improve the influence of chemoradiotherapy on immune function of patients, and reduce the levels of serum inflammatory factors,thus, which is worthy of clinical promotion.
引文
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2 Siegel RL,Miller KD,Fedewa SA,et al.Colorectal cancer statistics,2017.Ca A Cancer Journal for Clinicians,2017,67:104-17.
3 张桂燕.优质护理联合心理干预对血液透析患者焦虑自评量表及抑郁自评量表情况的影响研究.山西医药杂志,2016,45:970-973..
4 李香花,唐尔波,黄美珠,等.恶性肿瘤化疗患者焦虑和抑郁的调查研究及心理干预.重庆医学,2016,45:538-540.
5 刘力婕,邹艳玲,薛志芳,等.快速康复外科在胰腺癌术后对血清IL-6、IL-10、TNF-α水平的影响.重庆医学,2015,44:2635-2637.
6 薛晓静,王晓贞,段红红,等.综合护理干预在晚期胰腺癌放疗联合同步化疗中的临床应用.中国医药导报,2017,14:170-173.
7 Chung HC,Jeung HC,Kim SJ,et al.FKBP5 polymorphisms as vulnerability to anxiety and depression in patients with advanced gastric cancer:A controlled and prospective study.Psychoneuroendocrinology,2012,37:1569-1576.
8 汪正广,齐东江,李嘉嘉,等.中晚期胃癌患者术后化疗联合黄芪颗粒治疗对生活质量及免疫功能的影响.安徽医科大学学报,2014,49:1771-1774.
9 孟令新,丁兆军,陈希平.热疗联合腹腔热灌注化疗治疗胰腺癌并腹腔积液的疗效观察.中华临床医师杂志(电子版),2011,5:1923-1927.
10 张念华,陈高峰,史清华,等.腹腔灌注化疗联合内生场热疗在胰腺癌恶性腹水中的应用研究.新医学,2012,43:19-22.
11 李春梅,张林,侯艳红,等.胰腺癌术后肠内营养与肠外营养的Meta分析.临床消化病杂志,2015,27:27-31.
12 蒋莎莎,张军,齐彦宇,等.早期肠内免疫营养干预对胰腺癌术后胃肠激素、应激激素及免疫应答的影响.海南医学院学报,2017,23:2266-2269.
2 Siegel RL,Miller KD,Fedewa SA,et al.Colorectal cancer statistics,2017.Ca A Cancer Journal for Clinicians,2017,67:104-17.
3 张桂燕.优质护理联合心理干预对血液透析患者焦虑自评量表及抑郁自评量表情况的影响研究.山西医药杂志,2016,45:970-973..
4 李香花,唐尔波,黄美珠,等.恶性肿瘤化疗患者焦虑和抑郁的调查研究及心理干预.重庆医学,2016,45:538-540.
5 刘力婕,邹艳玲,薛志芳,等.快速康复外科在胰腺癌术后对血清IL-6、IL-10、TNF-α水平的影响.重庆医学,2015,44:2635-2637.
6 薛晓静,王晓贞,段红红,等.综合护理干预在晚期胰腺癌放疗联合同步化疗中的临床应用.中国医药导报,2017,14:170-173.
7 Chung HC,Jeung HC,Kim SJ,et al.FKBP5 polymorphisms as vulnerability to anxiety and depression in patients with advanced gastric cancer:A controlled and prospective study.Psychoneuroendocrinology,2012,37:1569-1576.
8 汪正广,齐东江,李嘉嘉,等.中晚期胃癌患者术后化疗联合黄芪颗粒治疗对生活质量及免疫功能的影响.安徽医科大学学报,2014,49:1771-1774.
9 孟令新,丁兆军,陈希平.热疗联合腹腔热灌注化疗治疗胰腺癌并腹腔积液的疗效观察.中华临床医师杂志(电子版),2011,5:1923-1927.
10 张念华,陈高峰,史清华,等.腹腔灌注化疗联合内生场热疗在胰腺癌恶性腹水中的应用研究.新医学,2012,43:19-22.
11 李春梅,张林,侯艳红,等.胰腺癌术后肠内营养与肠外营养的Meta分析.临床消化病杂志,2015,27:27-31.
12 蒋莎莎,张军,齐彦宇,等.早期肠内免疫营养干预对胰腺癌术后胃肠激素、应激激素及免疫应答的影响.海南医学院学报,2017,23:2266-2269.