The Effect Of Psycho-intervention On Stress Reaction In Perioperative Patients With Gastric Cancer

Objective With the development of medical science, medical psychology has been gradually recognized and valued. Generally cancer patients have many psychological problems before operations, which will seriously affect the operation and prognosis. Thus, this paper aims to study the effect of psycho-intervention on stress reaction in perioperative patients with gastric cancer.Method Cases of gastric cancer operations were observed and analyzed during June 2007 and February 2010 in Fujian Tumor Hospital. Sixty male patients with gastric cancer from 1 year to 5 years of disease course with the average age of 50 received radical total gastrectomy, and the staging of tumor was T1-T3 while ASA level was I~II. All these patients were informed, and volunteered to receive the psycho-intervention treatment. Then the patients were randomly divided into Intervention Group (n=30) and Control Group (n=30). Patients in Intervention Group received the psycho-intervention of 20 minutes including mental support,health education and relax training 1 day before the operation, before the anaesthesia and 3 hours after the operation, while Control Group only got routine introductions about anaesthesia from the anesthesiologist before the operation. General anesthesia of vein induction and tracheal intubation was applied to all patients in the two groups; intravenous inhalational anesthesia was applied during the operation; and the postoperative extubation was performed after the consciousness of patients while the antagonist was not given during the analepsia. Then the systolic pressure and heart rate of the two groups were compared the time to hospital, after entering the operating room, during the operation and 30min after skin incision, during the extraction of tracheal intubation. Meanwhile, the index of blood glucose, concentration of cortisol and epinephrine of both groups were observed after entering the operating room, 30min of the perioperation and 3h after the operation. Finally the postoperative (3h,6h,12h) pain score, the use rate of analgesics, adverse reactions such as nausea, vomiting and recovery between the two groups were examined..Results Compared with Intervention Group, the levels of systolic pressure and heart rate of Control Group the time to hospital, after entering the operating room, during the operation and 30min after skin incision, during the extraction of tracheal intubation were 115±20 vs.120±13mmHg, 76±5 vs.68±8 beats/min , 136±9 vs.125±16mmHg, 88±7 vs. 77±9 beats/min,126±20 vs. 130±16mmHg, 79±6vs. 82±9 beats/min , 112±13vs. 106±9mmHg, 77±9vs. 80±6 beats/min , 145±15 vs. 135±8mmHg, 86±13 vs. 75±7 beats/min, and the index of blood glucose, concentration of cortisol and epinephrine after entering the operating room, 30min of the perioperation and 3h after the operation were 4.7±0.8 vs. 4.0±0.5 mmol/L, 333±25 vs. 255±61 nmol/L, 73±3 vs. 42±7 pg/ml,6.9±0.5 vs. 5.8±0.8 mmol/L, 405±17 vs. 350±28 nmol/L, 62±8 vs. 38±9 pg/ml,9.2±0.7 vs. 8.3±0.9 mmol/L, 385±45 vs. 300±31 nmol/L, 55±3 vs. 40±7 pg/ml. The postoperative (3h, 6h, 12h) pain score was 3.8±1.6vs. 3.0±1.7,6.9±1.7 vs. 4.5±1.8,6.9±1.5vs. 5.6±1.3, the use rate of analgesics (83.3% vs. 33.3%), the incidence rate of nausea and vomiting (30% vs. 20%), the anus exhaust time (46.4±5.9 vs. 39.5±7.7 h), the exercise time (42.1±6.5 vs. 38.2±5.8h). The difference of systolic pressure and heart rate of the two groups was statistically significant (p<0.05) after entering the operating room and during the extraction of tracheal intubation. And the index of blood glucose, concentration of cortisol and epinephrine after entering the operating room, 30min of the perioperation and 3h after the operation was significantly different (p<0.05). Besides, the difference of the postoperative (3h,6h,12h) pain score, the use rate of analgesics, the incidence rate of nausea and vomiting, the anus exhaust time and the exercise time was also statistically significant (p<0.05). However, there was no significant difference (p>0.05) for the systolic pressure and heart rate of the two groups the time to hospital, during the operation and 30min after skin incision.Conclusions Psycho-intervention can reduce the stress reaction, postoperative complications of patients with gastric cancer and can promote the rehabilitation.