摘要
目的:探讨心理健康教育为主的综合干预对患子宫肌瘤需行经腹子宫全切术年轻患者的心理应激反应的作用。方法:选取符合入组标准的40例患子宫肌瘤需行经腹子宫全切术的年轻患者,对干预组(20例)进行术前心理健康教育为主的综合干预。在两组入院第二天(T1)、手术前即干预后(T2)分别行HAMA、HAMD测定,在T1、T2、术后第二天(T3)测定血清皮质醇、白介素-6浓度。结果:(1)行经腹子宫全切术的年轻患者入院时均有焦虑、抑郁症状,干预后干预组汉密尔顿焦虑量表评分从14.4±5.9降低为9.1±4.2,汉密尔顿抑郁量表评分从17.8±3.5降低为9.4±6.8,组内、组间比较差异具有统计学意义。(2)心理干预组血清皮质醇T213.4±3.9ug/dl、T314.2±4.8ug/dl较T116.6±4.0ug/dl明显降低,与对照组相比T2血清皮质醇差异具有统计学意义(13.4±3.9/15.5±4.3ug/dl,t=2.10,P=0.05)。(3)白介素-6组内组间比较差异均未达到统计学意义。结论:应重视子宫全切术患者存在的心理问题,通过术前心理健康教育为主的综合干预,能降低围术期心理应激水平。
Objective： To explore the effect of integrated intervention on peri-operative stress of young patients with total hysterectomy. Methods： 40 young patients with total hysterectomy were selected continuously. 20 of them received integrated intervention before operations. With HAMA and HAMD, both groups were assessed on mood status when they admitted （T1 ） and before the operation （ T2 ） ; The serum concentration of cortisone and IL - 6 at T1, T2 and the second day after operation （ T3 ） were also tested. Results：（ 1 ） The young patients with hysterectomy showed distinct anxiety or depression symptoms when they admitted hospital. After integrated 1 intervention, the HAMA score of the interventional group decreased froml4. 4 ± 5.9 to 9. 1 ± 4. 2 ; HAMD score from 17. 8 ±3. 5 fell to 9.4 ± 6. 8. （ 2 ） The cortisone level of the interventional group changed from 16.6± 4.0 ug,/dl （ T1 ） to 13.4 ±3.9 ug/dl （ T2 ） and 14. 2 ±4. 8 ug,/dl （ T3 ） . Compared with the control group, the cortisone level of the intervention group was significantly lower at T2 （ 13.4 ± 3.9/15. 5 ± 4. 3 ug,/dl, t = 2. 10, P = 0. 05 ） . （ 3 ） The IL - 6 concentration between the two groups was no significant difference, Conclusion： The mood status of patients facing hysterectomy calls more attention, integrated psychological intervention mainly about health could decrease the peri-operative psychological stress.
出处
《中国心理卫生杂志》
CSSCI
CSCD
北大核心
2007年第9期638-642,共5页
Chinese Mental Health Journal
关键词
子宫肌瘤
子宫全切术
心理应激
健康教育
皮质醇
白介素-6
随机对照研究
uterine leiomyomas
hysterectomy
psychological stress
health education
cortisone
IL - 6
random controlled research
