美罗华联合CHOP方案治疗弥漫性大B细胞淋巴瘤患者中的应用研究及护理
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摘要
目的:探析在弥漫性大B细胞淋巴瘤病人的护理干预中予以CHOP方案与美罗华联合治疗的临床效果。方法:入选本院2016年6月至2017年5月收治的70例弥漫性大B细胞淋巴瘤病人,根据随机数字表法分为研究组、对照组,每组35例,两组均进行美罗华联合CHOP方案疗法,每21d为一个治疗周期,治疗6个周期,研究组实施持续质量改进(CQI)护理模式,对照组进行基础护理,比较两组的近期临床效果、用药后不良反应发生情况、护理满意度及依从性,以及护理前后生活质量变化。结果:研究组的近期临床有效率为82.9%,对照组的近期临床有效率为60.0%,两组比较差异有统计学意义(P <0.05);研究组用药后发生带状疱疹、转氨酶升高、发热畏寒、骨髓抑制、贫血、消化道不适、白细胞降低等不良反应显著低于对照组,差异有统计学意义(P <0.05);研究组的护理满意率、护理依从性分别为77.1%、91.4%,对照组的护理满意率、护理依从性分别为62.9%、65.7%,两组比较差异有统计学意义(P <0.05)。两组护理后生活质量评分中食欲、睡眠、精神状态、疲乏以及日常活动等指标均优于护理前,其中研究组各项生活质量评分均优于对照组,差异对比具有统计学意义(P <0.05)。结论:弥漫性大B细胞淋巴瘤病人进行美罗华联合CHOP方案疗法,全程予以干预性护理,临床效果确切,可显著延长病人的生存期,降低用药后不良反应发生率,提高护理依从性及满意度。
Objective:To explore the application and effect of nursing intervention in patients with diffuse large B cell lymphoma treated with rituximab combined with CHOP regimen.Methods:70 diffuse large B cell lymphoma patients were selected in our hospital from June 2016 to May 2017,according to randomly divided into study group and control group,35 cases in each group,two groups were given rituximab in combination with chop regimen,every 21 days for a treatment cycle for six cycles of treatment,the study group carried out the nursing mode of continuous quality improvement(CQI),the control group carried out basic nursing,compared the recent clinical effect,the occurrence of adverse reaction after medication,the satisfaction and compliance of the two groups,and the quality of life before and after nursing.Results:The short-term clinical effective rate in study group was 82.9%,control group was 60.0%,there was significant difference between two groups(P <0.05);the adverse reactions of herpes zoster,aminotransferase,fever and chilling,myelosuppression,anemia,digestive tract discomfort and leukocyte reduction were significantly lower in the study group than in the control group,with a significant difference(P <0.05).The nursing satisfaction rate and nursing compliance of the study group were 77.1% and 91.4%respectively,the nursing satisfaction rate and nursing compliance in the control group were 62.9% and 65.7%respectively,there were significant differences in the two groups(P <0.05).The indexes of appetite,sleep,mental state,fatigue and daily activity in the quality of life score of the two groups were superior to those before nursing,and the scores of the quality of life of the study group were all better than those in the control group,and the difference was statistically significant(P <0.05).Conclusion:Diffuse large B cell lymphoma patients rituximab in combination with chop regimen,whole be intervention nursing,have clinical curative effect,can significantly prolong the survival time of the patients,reduce the drug adverse reactions,and improve the compliance of nursing and satisfaction.
Objective:To explore the application and effect of nursing intervention in patients with diffuse large B cell lymphoma treated with rituximab combined with CHOP regimen.Methods:70 diffuse large B cell lymphoma patients were selected in our hospital from June 2016 to May 2017,according to randomly divided into study group and control group,35 cases in each group,two groups were given rituximab in combination with chop regimen,every 21 days for a treatment cycle for six cycles of treatment,the study group carried out the nursing mode of continuous quality improvement(CQI),the control group carried out basic nursing,compared the recent clinical effect,the occurrence of adverse reaction after medication,the satisfaction and compliance of the two groups,and the quality of life before and after nursing.Results:The short-term clinical effective rate in study group was 82.9%,control group was 60.0%,there was significant difference between two groups(P <0.05);the adverse reactions of herpes zoster,aminotransferase,fever and chilling,myelosuppression,anemia,digestive tract discomfort and leukocyte reduction were significantly lower in the study group than in the control group,with a significant difference(P <0.05).The nursing satisfaction rate and nursing compliance of the study group were 77.1% and 91.4%respectively,the nursing satisfaction rate and nursing compliance in the control group were 62.9% and 65.7%respectively,there were significant differences in the two groups(P <0.05).The indexes of appetite,sleep,mental state,fatigue and daily activity in the quality of life score of the two groups were superior to those before nursing,and the scores of the quality of life of the study group were all better than those in the control group,and the difference was statistically significant(P <0.05).Conclusion:Diffuse large B cell lymphoma patients rituximab in combination with chop regimen,whole be intervention nursing,have clinical curative effect,can significantly prolong the survival time of the patients,reduce the drug adverse reactions,and improve the compliance of nursing and satisfaction.
引文
[1]王丽萍,马莉.R-CHOP方案治疗68例弥漫大B细胞淋巴瘤不良反应的观察及护理[J].河南科技大学学报(医学版),2013,31(03):226-227.
[2]于晓娟,白云娟,王晓媛,等.高龄恶性淋巴瘤患者美罗华加CHOP方案化疗的护理[J].中国医药导刊,2011,13(01):152-153.
[3]李兰花.一例原发性外阴非霍奇金淋巴瘤合并温冷双抗体型自身免疫性溶血性贫血患者的护理[J].中国实用护理杂志,2015,31(15):1145-1147.
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[5]徐琪,沈丽,陈曦,等.护理干预对联合化疗弥漫性大B细胞淋巴瘤患者心理状态及生活质量的影响[J].中华现代护理杂志,2013,19(19):2252-2254.
[6]El-Galaly T C,Jakobsen L H,Hutchings M,et al.Routine imaging for diffuse large B-cell lymphoma in first complete remission does not improve post-treatment survival:a DanishSwedish population-based study[J].J Clin Oncol,2015,05(06):286-289.
[7]张琨,霍花,颜霞.1例非霍奇金淋巴瘤术后患者行超声引导下PICC置管及出院后的延续性护理服务[J].中国实用护理杂志,2014,30(z1):139-140.
[8]刘凤玲,李丹.子宫弥漫性大B细胞淋巴瘤心理护理1例[J].河北医药,2012,34(23):3677-3678.
[9]黄胜,许容芳,姚丹,等.持续质量改进在弥漫大B细胞淋巴瘤化疗管理中的应用[J].护理管理杂志,2014,14(07):488-490.
[10]李春霞,丁小崇,宋波.CHOP方案单用与联合美罗华治疗弥漫大B细胞淋巴瘤疗效比较[J].中国实用医刊,2014,41(09):94-96.
[11]赵羽,寇伟,陈琪.用于利妥昔单抗时代的弥漫大B细胞淋巴瘤患者的改良的国际预后指数[J].中华临床医学杂志(电子版),2014,16(14):3066-3067.
[12]曾爱屏,于起涛,周韶璋,等.美罗华联合CHOP方案治疗弥漫性大B细胞淋巴瘤的疗效观察[J].中国癌症防治杂志,2013,02(06):151-153,154.
[13]曲华,陈娜飞,陈铁虎.利妥昔单抗联合CHOP方案治疗胃黏膜相关淋巴组织淋巴瘤的护理[J].现代中西医结合杂志,2014,18(26):2022-2024.
[14]徐琪,沈丽,陈曦.护理干预对联合化疗弥漫性大B细胞淋巴瘤患者心理状态及生活质量的影响[J].中华现代护理杂志,2013,19(19):2252-2254.
[15]张瑞春,金爽,廖丽昇.美罗华联合化疗治疗弥漫大B细胞淋巴瘤21例护理[J].齐鲁护理杂志,2010,16(05):54-55.
[2]于晓娟,白云娟,王晓媛,等.高龄恶性淋巴瘤患者美罗华加CHOP方案化疗的护理[J].中国医药导刊,2011,13(01):152-153.
[3]李兰花.一例原发性外阴非霍奇金淋巴瘤合并温冷双抗体型自身免疫性溶血性贫血患者的护理[J].中国实用护理杂志,2015,31(15):1145-1147.
[4]Ikebe T,Sasaki H,Saburi Y,et al.Bilateral psoas muscle lymphoma:an unusual presentation of EBV-positive diffuse large B-cell lymphoma of the elderly[J].Int J Hematol,2015,06(06):286-289.
[5]徐琪,沈丽,陈曦,等.护理干预对联合化疗弥漫性大B细胞淋巴瘤患者心理状态及生活质量的影响[J].中华现代护理杂志,2013,19(19):2252-2254.
[6]El-Galaly T C,Jakobsen L H,Hutchings M,et al.Routine imaging for diffuse large B-cell lymphoma in first complete remission does not improve post-treatment survival:a DanishSwedish population-based study[J].J Clin Oncol,2015,05(06):286-289.
[7]张琨,霍花,颜霞.1例非霍奇金淋巴瘤术后患者行超声引导下PICC置管及出院后的延续性护理服务[J].中国实用护理杂志,2014,30(z1):139-140.
[8]刘凤玲,李丹.子宫弥漫性大B细胞淋巴瘤心理护理1例[J].河北医药,2012,34(23):3677-3678.
[9]黄胜,许容芳,姚丹,等.持续质量改进在弥漫大B细胞淋巴瘤化疗管理中的应用[J].护理管理杂志,2014,14(07):488-490.
[10]李春霞,丁小崇,宋波.CHOP方案单用与联合美罗华治疗弥漫大B细胞淋巴瘤疗效比较[J].中国实用医刊,2014,41(09):94-96.
[11]赵羽,寇伟,陈琪.用于利妥昔单抗时代的弥漫大B细胞淋巴瘤患者的改良的国际预后指数[J].中华临床医学杂志(电子版),2014,16(14):3066-3067.
[12]曾爱屏,于起涛,周韶璋,等.美罗华联合CHOP方案治疗弥漫性大B细胞淋巴瘤的疗效观察[J].中国癌症防治杂志,2013,02(06):151-153,154.
[13]曲华,陈娜飞,陈铁虎.利妥昔单抗联合CHOP方案治疗胃黏膜相关淋巴组织淋巴瘤的护理[J].现代中西医结合杂志,2014,18(26):2022-2024.
[14]徐琪,沈丽,陈曦.护理干预对联合化疗弥漫性大B细胞淋巴瘤患者心理状态及生活质量的影响[J].中华现代护理杂志,2013,19(19):2252-2254.
[15]张瑞春,金爽,廖丽昇.美罗华联合化疗治疗弥漫大B细胞淋巴瘤21例护理[J].齐鲁护理杂志,2010,16(05):54-55.