表柔比星联合正念干预泌尿系统肿瘤伴抑郁患者的临床价值。

IF 3.9 4区 医学 Q1 PSYCHIATRY World Journal of Psychiatry Pub Date : 2025-01-19 DOI:10.5498/wjp.v15.i1.98737
Juan Liu, Yan-Ping Guo, Yan-Mei Lu, Bei-Lin Wang
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引用次数: 0

摘要

背景:泌尿系统肿瘤患者常出现抑郁、烦躁等负性心理症状,严重影响免疫功能,间接影响肿瘤预后。虽然表柔比星(EPI)是欧洲泌尿外科协会推荐的药物,可以改善预后,但长期使用会引起毒副作用,降低治疗依从性,增加心理负担。因此,适当的干预方式是必要的。目的:探讨EPI联合正念干预在泌尿系统肿瘤伴抑郁患者中的临床应用价值。方法:这是一项回顾性研究,包括2021年3月至2023年7月驻马店中心医院收治的110例泌尿系统肿瘤和抑郁症患者。患者分为常规组(n = 55)和联合干预组(n = 55)。常规组给予丝裂霉素和常规护理,联合干预组给予EPI和正念干预。两组患者均接受了三个周期的化疗。评估免疫功能(CD4+细胞、CD8+细胞、CD4+/CD8+比值)、肿瘤标志物水平[膀胱癌抗原(UBC)、膀胱肿瘤抗原(BTA)和核基质蛋白22 (NMP22)]、生活质量问卷-核心30 (QLQ-C30)、17项汉密尔顿抑郁量表(HAMD-17)、癌症相关疲劳量表(CFS)。记录不良反应及护理满意度并进行评价。结果:干预后两组患者CD4+、CD8+及CD4+/CD8+水平均升高,以联合干预组改善更为显著(P < 0.05)。联合干预组肿瘤标志物(NMP22、BTA、UBC)水平低于常规组(P < 0.05)。联合干预组HAMD-17评分降低幅度更大(9.38±3.12 vs 15.45±4.86,P < 0.05), QLQ-C30评分升高,CFS评分降低(P < 0.05)。联合干预组不良反应发生率较低,护理满意度较高(P < 0.05)。结论:EPI联合正念干预可显著改善泌尿系统肿瘤合并抑郁患者的临床疗效,值得临床推广应用。
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Clinical value of combining epirubicin with mindfulness intervention in patients with urinary system tumors and depression.

Background: Urinary system tumors often cause negative psychological symptoms, such as depression and dysphoria which significantly impact immune function and indirectly affect cancer prognosis. While epirubicin (EPI) is recommended by the European Association of Urology and can improve prognosis, its long-term use can cause toxic side effects, reduce treatment compliance, and increase psychological burden. Therefore, an appropriate intervention mode is necessary.

Aim: To explore the clinical value of EPI combined with mindfulness intervention in patients with urinary system tumors and depression.

Methods: This was a retrospective study including 110 patients with urinary system tumors and depression admitted to Zhumadian Central Hospital between March 2021 and July 2023. Patients were divided into conventional (n = 55) and joint intervention (n = 55) groups. The conventional group received mitomycin and routine nursing, while the joint intervention group received EPI and mindfulness intervention. Both groups underwent three cycles of chemotherapy. Immune function (CD4+ cells, CD8+ cells, CD4+/CD8+ ratio), tumor marker levels [urinary bladder cancer antigen (UBC), bladder tumor antigen (BTA) and nuclear matrix protein 22 (NMP22)], quality of life questionnaire-core 30 (QLQ-C30), 17-item Hamilton depression scale (HAMD-17), and cancer-related fatigue [cancer fatigue scale (CFS)] were assessed. Adverse reactions and nursing satisfaction were recorded and evaluated.

Results: Post-intervention, CD4+, CD8+, and CD4+/CD8+ levels increased in both groups, with the joint intervention group showing more significant improvement (P < 0.05). Tumor marker levels (NMP22, BTA, and UBC) were lower in the joint intervention group compared to the conventional group (P < 0.05). The joint intervention group also showed a greater reduction in HAMD-17 scores (9.38 ± 3.12 vs 15.45 ± 4.86, P < 0.05), higher QLQ-C30 scores, and lower CFS scores (both P < 0.05). Additionally, the joint intervention group had a lower incidence of adverse reactions and higher nursing satisfaction (P < 0.05).

Conclusion: EPI combined with mindfulness intervention significantly improved clinical outcomes in patients with urinary system tumors and depression and is worthy of clinical application.

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期刊介绍: The World Journal of Psychiatry (WJP) is a high-quality, peer reviewed, open-access journal. The primary task of WJP is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of psychiatry. In order to promote productive academic communication, the peer review process for the WJP is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJP are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in psychiatry.
期刊最新文献
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