| Objective:To explore the effects of the neuroendocrine hormone and immune function on preoperative anxiety in patients with liver cancer and to evaluat the effect of its nursing intervention.Methods:Assessed the patients with liver cancer using self-rating anxiety scale (SAS) and 132 cases were selected as anxiety group (Group A) meanwhile the non-anxiety patients were matched 132 cases of anxiety as the control group (Group B). Then, Group A and Group B were divided into four subgroups including psychological + drug intervention group, psychological intervention group, drug intervention group, non-intervention group in accordance with the random number table. Compared with the ACTH,cortisol,CD3+,CD4+,CD8+,CD4+/ CD8+,IAP,sIL-2R,IL-6,IgG,IgA,IgM,SAS of all patients who were preoperative and of the patients in subgroups on day1,4,7,14,30 after operation. ACTH and cortisol were measured by radioimmunoassay method,CD3+and CD4+and CD8+and CD4+/ CD8+were measured by flow cytometry method , IgG and IgA and IgM were measured by immunoturbidimetric assay, IAP and sIL-2Rand IL-6 were measured by double-antibody sandwich ELISA method.Results:1.The ACTH and cortisol of anxiety group was significantly higher than the non-anxiety group,s in preoperation (P﹤0.05). The ACTH and cortisol had increased in each group but those of the anxiety group increased more than the non-anxiety group after operation. (P﹤0.05).2.The ACTH and cortisol of psychological + drug intervention group and psychological intervention group were lower than that of the drug intervention group and non-intervention group in postoperative patients on day 1,4,7,14,30 in anxiety group(P﹤0.05). The ACTH and cortisol of psychological + drug intervention group and psychological intervention group were slightly lower than the drug intervention group and non-intervention group in postoperative patients of the non-anxiety group on day1,4, but there was no significant difference(P﹥0.05).3.The immune function of the anxiety group,s patients was significantly lower than that of the non-anxiety group,s in preoperation (P﹤0.05). The immune function had declined in each groupbut that of the anxiety groups, patients decreased more than the non-anxiety groups, after operation(P﹤0.05).4.The immune function of psychological + drug intervention group and psychological intervention group were superior than the drug intervention group and non-intervention group of postoperative patients in anxiety group on day 4,7,14,30(P﹤0.05). The immune function of psychological + drug intervention group and psychological intervention group were slightly higher than the drug intervention group and non-intervention group of postoperative patients in non-anxiety group on day 4,7,14,30,but there was no significant difference(P﹥0.05).5.The SAS of psychological + drug intervention group and psychological intervention group were lower than the drug intervention group and non-intervention group of postoperative patients in anxiety group on day7(P﹤0.05), The SAS of psychological + drug intervention group,psychological intervention group and drug intervention group were lower than that of the non-intervention group in postoperative patients in anxiety group on day14,30(P﹤0.05).Conclusions:1.Preoperative anxiety in patients with HCC could be a source of stress caused the patient's stress response and immune suppression at the same time. Anxiety and surgery both existed could cause the neuroendocrine hormone levels increased greater and the immune function decreased even more.2.Psychological + drug intervention or psychological intervention could promote the neuroendocrine hormone and immune function recovery of the preoperative anxious patients with HCC after operation..3.Psychological + drug intervention or psychological intervention or drug intervention could reduce the levels of the anxiety in patients with HCC effectly. The effect of the intervention by drug intervention only was not obviously than that by psychological + drug intervention or psychological intervention during the early postoperation. |
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