经颅电刺激提高前列腺癌术后患者的抗逆性

A. Penzhoyan, G. Penzhoyan, S. Akhedzhak-Naguze, V. Abushkevich, A. Burlutskaya
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摘要

在前列腺癌手术后的康复期,男性的焦虑往往会增加。此外,还观察到勃起功能障碍的同时发展。这会导致心理-情绪压力的形成。本研究旨在探讨经颅电刺激(transcranial electrical stimulation, tES)对不同类型前列腺癌手术后康复期应激易损性的影响。材料与方法。作者对124名前列腺癌手术后6个月的男性的焦虑水平和勃起功能障碍进行了评估。根据手术类型将患者分为两组:第一组(24例)-高强度聚焦超声(HIFU);第二组(50例):腹腔镜根治性前列腺切除术;第三组(n=50) -剖腹根治性前列腺切除术。根据N.V. Kirsheva和N.V. Ryabchikova试验、Holmes和Rahe应激量表、S. Cohen和G. Williamson试验及“预后”法测定tES前后血清促肾上腺皮质激素(ACTH)、皮质醇、肾上腺素、白细胞介素1和白细胞介素2 (IL-1、IL-2)浓度及应激易损性水平。结果。37例患者根治性前列腺切除术后6个月出现勃起功能障碍(第二组,n=17;第三组,n=20)。第一组(HIFU)患者均恢复勃起。无论手术类型和功能障碍的严重程度如何,所有患者都观察到应激易感性的降低。tES治疗后,ACTH、皮质醇、IL-1、IL-2水平显著降低(p<0.05)。根据所使用的所有测试,无论手术类型如何,都注意到应激易感性的显著增加(p<0.001)。结论。在康复期间功能障碍发展的频率方面,HIFU优于根治性前列腺切除术,无论手术入路如何。术后6个月经颅电刺激可显著降低患者血清应激激素和白细胞介素水平;无论手术类型和功能障碍如何,都会增加应激脆弱性。此外,te可以推荐给前列腺癌手术后的所有患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
INCREASING STRESS RESISTANCE BY TRANSCRANIAL ELECTRICAL STIMULATION IN PATIENTS AFTER PROSTATE CANCER SURGERY
Anxiety in men often increases during the rehabilitation period after prostate cancer surgery. Moreover, simultaneous development of erectile dysfunction is also observed. This contributes to psycho-emotional stress formation. The aim of the study is to evaluate the effect of transcranial electrical stimulation (tES) on stress vulnerability during the rehabilitation period after various types of prostate cancer surgery. Materials and Methods. The authors estimated anxiety level and erectile dysfunction in 124 men 6 months after prostate cancer surgery. The patients were divided into groups according to the surgery type: Group 1 (n=24) – high-intensity focused ultrasound (HIFU); Group 2 (n=50) – laparoscopic radical prostatectomy; Group 3 (n=50) – laparotomic radical prostatectomy. Serum concentration of adrenocorticotropic hormone (ACTH), cortisol, adrenaline, interleukins 1 and interleukins 2 (IL-1, IL-2) and stress vulnerability level according to N.V. Kirsheva and N.V. Ryabchikova test, Holmes and Rahe stress scale, S. Cohen and G. Williamson test, and “Prognosis” method was determined twice: before and after tES. Results. Erectile dysfunction was detected in 37 patients 6 months after radical prostatectomy (Group 2, n=17; Group 3, n=20). All the patients of Group 1 (HIFU) restored erection. A decrease in stress vulnerability was observed in all patients, regardless of the surgery type and the severity of functional disorders. After tES, a significant decrease in the levels of ACTH, cortisol, IL-1, IL-2 was estimated (p<0.05). According to all tests used, a significant increase in stress vulnerability was noted, regardless of the type of surgery (p<0.001). Conclusion. In terms of frequency of functional disorder development during the rehabilitation period, HIFU has advantages over radical prostatectomy, regardless of the surgical approach. Transcranial electrical stimulation 6 months after surgery significantly reduces the level of stress hormones and interleukins in patients’ blood serum; increases stress vulnerability regardless of the surgery type and functional disorders. Moreover, tES can be recommended for all patients after prostate cancer surgery.
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