| BackgroundSurgery and anaesthesia as strong stressors may bring violent psychological and physiological stress reactions to patients and lead to a series of changes of psychology endocrine and immune, Then effect the progress and prognosis of disease. Surgical stress response is a physical and psychological syndrome caused by the psychological reactions, such as fear, anxiety and tension, and the physical interference with the operation. It plays an important role in the process of the mechanism of adverse reactions and major complications of the patients. Patients with the fear of surgery and the desire of the recovery can lead to serious psychological conflicts that may seriously disturbed mental steady. As the day approaches and the reaction intensified, coupled with physical interference in the operation, jointly led to a series of physiological disorder. Due to the environment, the role and emotions are in a state of adjustment, in addition to unknown of the surgery information, patients have often leads to anxiety-based mental stress response.There is ongoing debate about the impact of psychological interventions on the stress reaction after surgery. Significant reductions in cancer patients'emotional distress can be achieved with interventions, particularly for those patients with high levels of distress. It is hypothesized that stress reduction interacts withneuroendocrine and/or immune responses to yield improved illness or disease outcomes.Meningioma is a common intracranial tumor, the most common benign tumor, rarely malignant, the treatment of choice for treatment. Although most of the meningiomas are benign, because of intracranial tumors, the malignant also possible, and easy to relapse, the disease has caused tremendous psychological pressure on the patients. The psychological pressure caused by the disease, in addition to the surgical stress, often lead to negative emotional response of patients, such as anxiety, depression etc.The new bio-psycho-social model emphasizes the active function of psychological factors in the human capacity to adjust and adapt to the functional activities. With the in-depth study of immune neuro-psychology, Psychological research shows that the majority of foreign intervention in reducing perioperative period in patients with anxiety and depression. can also enhance the immune function in varying degrees. Domestic counterparts are also increasingly concerned about the psychological and psychosocial factors in patients with neuroendocrine tumor of the impact. Most psychological intervention are for breast cancer research. Studies on the patients with brain tumors are always using general psychological care to alleviate the anxiety level in patients. Seldom there are studies on the effect of psychological intervention on the neuroendocrine and the immune system of patients with brain tumors.Objective:To study the effect of psychological intervention on the emotion and neuroendocrine system of patients with meningiomas before surgery. And probe into the model of psychological intervention that suitable for clinical. Our study applied randomized controlled trials, through a series of standard psychological intervention of the patients with meningiomas, such as cognitive therapy and psychological counseling. Individual music relaxation therapy etc, to study the role of this psychological intervention programs on reducing the psychological stress and the impact on the neuroendocrine and immune system of patients with meningioma. Then we can determine the effectiveness and clinical feasibility of this psychological intervention model.Materials and Methods:This study is a prospective, randomized, control clinical experiment. Patients were randomly assigned either to experiment group (30patients) or control group (30 patients). Patients in experiment group received psychological intervention of our study from the second day in hospital until the morning of operation day. Through patient interviews and survey researchers used psychological intervention including targeted cognitive therapy, exchanges, social support and music relaxation therapy and other psychological interventions for patients in the experimental group. Patients in surgery control group received general preoperative care. Changes ofanxiety and depression, ACTH and NE in plasma were compared between the two groups.Results:1. There is no statistical difference in age, gender, education level, economic status, and the knowledge of disease in two groups.2. On the second day of admission there is no difference in SAS (t=0.726, p=0.471>0.05) and SDS(t=1.575, p=0.121>0.05) between two groups. On the morning of surgery there is evident difference in SAS (t=2.534, p=0.014<0.05) and no difference in SDS(t=0.918, p=0.363>0.05); Either group has evident difference of SAS on the morning of surgery compared with the second day of admission (the experiment group:t=4.928, p=0.01<0.05; the control group: t=1.57, p=0.027<0.05).3. On the second day of admission there is no difference in ACTH (t=0.365, p=0.717>0.050 and NE(t=0.364, p=0.727>0.05) between two groups. On the morning of surgery there is evident difference in ACTH (t=2.157, p=0.035<0.05) and NE(t=3.299, p=0.002<0.05); Either group has evident difference of ACTH (the experiment group t=8.45, p=0.01; the control group t=5.44, p=0.01) and NE (the experiment group t= 7.24, P=0.01; the control group t=1.79, p=0.04<0.05) on the morning of surgery compared with the second day of admission.Conclusions1. Surgical psychological stress can increase patients'anxiety anddepression before surgery.2. Psychological stress of surgical patients have effects on the neuroendocrine and immune system.3. The psychological intervention programs of experiment group can decrease the increasing extent of anxiety, ACTH and NE in plasma before surgery.4. The psychological intervention programs can reduce the surgical psychological stress on patients with meningiomas.
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