摘要
目的探讨认知行为疗法对胸腔镜下肺癌根治术老年患者焦虑及慢性疼痛的影响。方法将220例行胸腔镜下肺癌根治术的老年患者按照随机数字表法分为研究组110例和对照组110例。对照组患者从入院当天起至术前1 d给予常规治疗和护理干预,研究组患者从入院当天起至术前1 d实施认知行为疗法治疗。分别采用简易精神状态检查量表、汉密顿焦虑量表评估两组患者入院当天及术后7 d时的认知功能状况和焦虑状况,记录两组患者术后6 h、48 h内数字评分量表评分及Ramsay镇静评分量表评分,比较两组患者术后3个月和6个月的术后慢性疼痛发生率。结果与入院当天比较,术后7 d时两组患者简易精神状态检查量表评分和汉密顿焦虑量表评分均降低,且研究组患者简易精神状态检查量表评分高于对照组,汉密顿焦虑量表评分低于对照组(P<0.01)。与术后6 h比较,术后48 h时两组患者数字评分量表评分均降低,Ramsay镇静评分量表评分均升高(P<0.01)。术后研究组患者失访3例,对照组患者失访2例。术后3个月和6个月时研究组患者慢性疼痛总发生率均低于对照组(P<0.05)。结论认知行为疗法可减轻胸腔镜下肺癌根治术老年患者围术期的焦虑状态,降低术后慢性疼痛发生率。
Objective To explore the effects of cognitive-behavioral therapy(CBT)on anxiety and chronic pain in elderly patients undergoing thoracoscopic radical resection of lung cancer.Methods A total of 220 elderly patients undergoing thoracoscopic radical resection for lung cancer were divided into research(n=110)and control(n=110)group according to random number table.Research group received the CBT from the day of admission to the day before surgery and the control did routine medical care and nursing.Cognitive function and anxiety status of both groups were respectively assessed using the Mini-Mental State Examination(MMSE)and Hamilton Anxiety Scale(HAMA)on the day of admission and day 7 after surgery,scores on Numeric Rating Scale(NRS)and Ramsay Sedation Scale(RSS)were recorded within 6 and 48 hours after surgery,and the incidences of chronic postsurgical pain(CPSP)was compared between two groups in month 3 and 6 after surgery.Results Compared with the day of admission,the scores on the MMSE and HAMA of both groups lowered in day 7 after surgery and that on the MMSE was higher and the HAMA lower in research than control group(P<0.01).Compared with hour 6 after surgery,scores on the NRS of both groups lowered and the RSS elevated in hour 48 after surgery(P<0.01).Three patients in research and two in control group were lost to follow-up.The total incidences of the CPSP were lower in research than control group in 3 and 6 months after surgery(P<0.05).Conclusion CBT can alleviate perioperative anxiety and reduce the incidence of chronic postoperative pain in elderly patients undergoing thoracoscopic radical resection of lung cancer.
作者
宋静超
周俊辉
钟巍
奚高原
Song Jingchao;Zhou Junhui;Zhong Wei;Xi Gaoyuan(Henan Provincial Chest Hospital(Affiliated Chest Hospital of Zhengzhou University),Zhengzhou 450008,Henan,China)
出处
《临床心身疾病杂志》
CAS
2023年第6期85-90,共6页
Journal of Clinical Psychosomatic Diseases
基金
河南省医学科技攻关计划联合共建项目(编号LHGJ20200220)。
作者简介
宋静超,男,41岁,汉族,硕士,副高级职称。主要研究成果:发表学术论文10余篇。研究方向:围术期并发症的防治;通讯作者:周俊辉,Email:zhoujunhui1985@126.com。
