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医学论文范文:综合心理干预在老年晚期非小细胞肺癌化疗中的应用研究
【摘要】 目的 研究综合心理行为干预对老年晚期非小细胞肺癌(non-small cell lung cancer, NSCLC)化疗患者生存质量及依从性的影响。方法 采用随机、对照、配对的研究方法，将61名老年晚期非小细胞肺癌患者，分为对照组(n=31)及综合心理行为干预组(治疗组，n=30)，使用癌症生命质量核心量表EORTIC QLQ-C30(version 3)、焦虑自评量表(SAS)、抑郁自评量表(SDS)等进行测评，于干预前后行配对、对照评定。结果 与对照组比较患者的生活质量量表中的情绪功能、躯体功能、社会功能、整体健康状况得分提高，乏力症状有所缓解，依从性提高。结论 综合心理行为干预可提高老年晚期非小细胞肺癌患者的生存质量，提高1年生存率，减轻焦虑和抑郁，纠正患者消极的认知,提高其对化疗的依从性。
【关键词】 非小细胞肺癌; 老年;心理治疗; 化疗
The investigation of the application of comprehensive psychological intervention
in chemotherapy in elderly patients with non-small cell lung cancer
NI Bingqiang, ZHANG Zhihong, ZHENG Liangcheng, WU Meijuan, HUA Yuanchun
(Department of Oncology, The Fifth School of Clinical Medicine, Guangxi Medical University, Liuzhou, Guangxi 545006, China)
Abstract： Objective To investigate the influence of comprehensive therapy of psycho-behavioral intervention on the quality of life and the compliance with treatment among elderly patients with non-small cell lung cancer (NSCLC) who underwent chemotherapy. Methods 61 elderly patients with advanced non-small cell lung cancer were randomized into two groups: 30 cases in the comprehensive psycho-behavioral intervention group combined with chemotherapy and 31 cases in the control group with chemotherapy alone. The EORTIC QLQ-C30 (version 3), Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) scores were evaluated by paired-control before and after treatment. Results The scores of the life quality including the emotional function, cognitive function, social function, holistic health status, fatigue symptoms and compliance of the patients in the comprehensive intervention group were significantly different from those of patients in the control group. Conclusion The combination of comprehensive psycho-behavioral intervention and chemotherapy can improve the quality of life among elderly NSCLC patients, mitigate anxiety and depression and correct the negative cognitions so as to improve the compliance with chemotherapy.
Key words：non-small cell lung cancer (NSCLC); elderly patients; psychotherapy; chemotherapy医.学全.在.线网站www.med126.com
老年晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者常常体质差且伴其他慢性疾病，同时存在重要脏器功能衰退等。Ⅲb、Ⅳ期非小细胞肺癌术后及放疗后复发转移者，治疗大多采用以化疗为主的综合治疗方法。化疗对Ⅲb、Ⅳ期非小细胞肺癌的作用已得到肯定，但其存在高症状负荷和高流失率等[1]，因此我们利用心理干预配合化疗以期缓解症状，提高生存质量，增加患者对化疗的依从性，取得了较好效果，现报道如下。
1 资料和方法
1.1 一般资料 选择2005年1月—2008年2月住院的经X线、CT、MRI等影像学及组织、细胞学证实的Ⅲb、Ⅳ期非小细胞肺癌老年患者61例，分成治疗组(n=30)和对照组(n=31)。两组性别、年龄、病理分型、分期及化疗方法等经统计学处理均无差异(表1)。
