奥施康定联合放疗治疗恶性肿瘤并骨转移疼痛患者的护理研究
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摘要
目的:探究对于恶性肿瘤合并骨转移疼痛患者实施奥施康定联合放疗期间提供规范化护理程序干预的应用效果。方法:将本院于2015年5月-2017年1月间收治恶性肿瘤并骨转移疼痛患者80例,住院期间均提供羟考酮缓释片(奥施康定)联合放疗,同时实施恶性肿瘤骨转移疼痛规范化护理,干预后观察患者Mcmil Lan疼痛评分、生存质量评分、不良反应,评估心理抑郁状态。结果:患者入院时机体健康状态、日常活动能力、家庭融入度、社会功能等指标评分均较低,经治疗及护理干预后,患者上述指标评分均提高,比较差异均有统计学意义(P<0.05)。所有患者治疗前接受疼痛评分为(3.52±0.15)分,经奥施康定联合放疗干预,同时提供规范化疼痛护理后,再次测评为(2.21±0.10)分,干预后疼痛表现有所改善(P<0.05)。发生便秘反应为18例(22.50%),出现白细胞下降为5例(6.25%)。入院时患者抑郁评分结果平均为(70.26±1.40)分,出院时抑郁评分为(52.35±1.05)分,比较差异有统计学意义(P<0.05)。结论:本次研究采用奥施康定联合放疗措施治疗恶性肿瘤并骨转移疼痛患者,同时加强治疗期间规范化疼痛管理措施,制定标准护理程序,可有效减轻骨转移疼痛症状,提高患者治疗配合度及信心,抑郁表现得到缓解,大部分患者干预后生存状态较好。
Objective:To study the application effect of providing standardized nursing intervention for patients with malignant tumor and painful bone metastasis during the period of combined implementation of oxycontin and radiotherapy.Method:80 cases with malignant tumor and painful bone metastasis admitted to our hospital from May 2015 to January 2017 were provided the combined treatment of Oxy Contin(Oxycodone) and radiotherapy during hospitalization with standardized nursings of combined malignant tumor and painful bone metastasis implemented at the same time.After intervention,Mcmil Lan pain scores,life quality scores,and adverse reactions occurred to patients were observed and patients' psychological depression were evaluated.Result:The scores of patients' health status,activities of daily living,family integration,social function and other indicators were lower when the patients were admitted to hospital,the differences were statistically significant(P<0.05).After treatment and nursing intervention, the scores of these indexes were improved(P<0.05).In all cases,the average score of pain acceptance before treatment was(3.52±0.15)score,after the combined intervention of Oxycontin and radiotherapy in providing standardized pain care at the same time the score was(2.21±0.10) score when re-evaluating,after intervention the pain was improved(P<0.05).In all cases, the constipation reaction were 18 cases(22.50%),white blood cells decline were 5 cases(6.25%).The patients' average score of depression when admission was(70.26±1.40) score,and when discharge was(52.35±1.05) score,the difference was statistically significant(P<0.05).Conclusion:The study adopted the combination of Oxycontin with radiotherapy in the treatment of patients with malignant tumor and painful bone metastasis,at the same time to strengthen the standardized pain management measures implemented and standardized nursing process formulated during treatment,which can effectively relieve the symptoms of bone metastasis pain,improvepatients' treatment compatibility and confidence with depression relieved.Most patients have better living state after intervention.
Objective:To study the application effect of providing standardized nursing intervention for patients with malignant tumor and painful bone metastasis during the period of combined implementation of oxycontin and radiotherapy.Method:80 cases with malignant tumor and painful bone metastasis admitted to our hospital from May 2015 to January 2017 were provided the combined treatment of Oxy Contin(Oxycodone) and radiotherapy during hospitalization with standardized nursings of combined malignant tumor and painful bone metastasis implemented at the same time.After intervention,Mcmil Lan pain scores,life quality scores,and adverse reactions occurred to patients were observed and patients' psychological depression were evaluated.Result:The scores of patients' health status,activities of daily living,family integration,social function and other indicators were lower when the patients were admitted to hospital,the differences were statistically significant(P<0.05).After treatment and nursing intervention, the scores of these indexes were improved(P<0.05).In all cases,the average score of pain acceptance before treatment was(3.52±0.15)score,after the combined intervention of Oxycontin and radiotherapy in providing standardized pain care at the same time the score was(2.21±0.10) score when re-evaluating,after intervention the pain was improved(P<0.05).In all cases, the constipation reaction were 18 cases(22.50%),white blood cells decline were 5 cases(6.25%).The patients' average score of depression when admission was(70.26±1.40) score,and when discharge was(52.35±1.05) score,the difference was statistically significant(P<0.05).Conclusion:The study adopted the combination of Oxycontin with radiotherapy in the treatment of patients with malignant tumor and painful bone metastasis,at the same time to strengthen the standardized pain management measures implemented and standardized nursing process formulated during treatment,which can effectively relieve the symptoms of bone metastasis pain,improvepatients' treatment compatibility and confidence with depression relieved.Most patients have better living state after intervention.
引文
[1]周娟,杨蕾,袁长蓉,等.乳腺癌疼痛护理的研究进展[J].解放军护理杂志,2016,33(12):38-40,55.
[2]唐小丽,张婷,杨慧,等.四川省55所二级甲等及以上医院癌痛规范化护理的现状分析[J].中华护理杂志,2016,51(4):424-428.
[3]黄华.早期恶性肿瘤患者突破性肿瘤疼痛的评估及护理[J].中国实用医药,2016,11(18):255-256.
[4]穆培霞,张桂凌.个体化护理干预改善恶性肿瘤行放疗患者睡眠障碍的效果分析[J].中国实用医刊,2016,43(4):117-119.
[5]李颖,李萍,刘宸希,等.妇科恶性肿瘤癌性疼痛患者应用补充与替代医学干预的研究[J].中国实用护理杂志,2015,31(20):1486-1490.
[6]邱笑芬.骨转移瘤患者的心理护理[J].福建医药杂志,2001,23(3):182.
[7]陈秀霞,何少丽.疼痛护理干预在恶性肿瘤骨转移患者放疗止痛中的应用及效果[J].中外医学研究,2013,11(28):97-98.
[8]徐华清.妇科恶性肿瘤患者术后疼痛影响因素分析[J].辽宁医学院学报,2016,37(3):94-95.
[9]周淑如,李芳侠,张瑜,等.临床护理干预对晚期肺癌患者疼痛及生活质量的影响[J].中华肺部疾病杂志(电子版),2016,9(4):456-457.
[10]杨树青,聂晶晶,贾惠芬,等.肺癌骨转移瘤病人放疗后的护理[J].全科护理,2010,8(36):3343-3344.
[11]李艳,张海波,张馥丽,等.五行音乐联合穴位辐照对恶性肿瘤患者抑郁状态的影响[J].护士进修杂志,2016,31(18):1635-1638.
[12]张玉洁.目标性心理护理应用于恶性肿瘤术后化疗患者护理中的临床效果观察[J].中国实用医药,2016,11(24):218-219.
[13]梁寅寅,甘秀妮,王玉琼,等.延续护理在癌痛患者中的应用现状及思考[J].中国实用护理杂志,2015,31(33):2502-2505.
[14]王永明.适应模式在骨转移瘤护理中的应用[J].国外医学(护理学分册),2002,21(2):85-86.
[15]周爱华.骨转移瘤放疗后应用安慰护理的临床观察[J].中国美容医学,2012,21(14):438-439.
[16]李爱敏,李宁,李治,等.骨转移瘤放疗止痛的护理干预[J].医学信息,2014,27(20):344-345
[17]李皎宁.骨转移瘤患者的护理[J].海军总医院学报,2007,20(4):248-250.
[18]林玲,潘明治.66例骨转移瘤放疗的护理[J].中国实用医药,2009,4(36):210.
[19]顾冬梅.护理程序在肿瘤患者疼痛管理中的实施体会[J].护理学报,2012,19(14):44-45.
[20]杨月.恶性肿瘤晚期骨转移疼痛护理[J].中外医疗,2011,30(24):168.
[2]唐小丽,张婷,杨慧,等.四川省55所二级甲等及以上医院癌痛规范化护理的现状分析[J].中华护理杂志,2016,51(4):424-428.
[3]黄华.早期恶性肿瘤患者突破性肿瘤疼痛的评估及护理[J].中国实用医药,2016,11(18):255-256.
[4]穆培霞,张桂凌.个体化护理干预改善恶性肿瘤行放疗患者睡眠障碍的效果分析[J].中国实用医刊,2016,43(4):117-119.
[5]李颖,李萍,刘宸希,等.妇科恶性肿瘤癌性疼痛患者应用补充与替代医学干预的研究[J].中国实用护理杂志,2015,31(20):1486-1490.
[6]邱笑芬.骨转移瘤患者的心理护理[J].福建医药杂志,2001,23(3):182.
[7]陈秀霞,何少丽.疼痛护理干预在恶性肿瘤骨转移患者放疗止痛中的应用及效果[J].中外医学研究,2013,11(28):97-98.
[8]徐华清.妇科恶性肿瘤患者术后疼痛影响因素分析[J].辽宁医学院学报,2016,37(3):94-95.
[9]周淑如,李芳侠,张瑜,等.临床护理干预对晚期肺癌患者疼痛及生活质量的影响[J].中华肺部疾病杂志(电子版),2016,9(4):456-457.
[10]杨树青,聂晶晶,贾惠芬,等.肺癌骨转移瘤病人放疗后的护理[J].全科护理,2010,8(36):3343-3344.
[11]李艳,张海波,张馥丽,等.五行音乐联合穴位辐照对恶性肿瘤患者抑郁状态的影响[J].护士进修杂志,2016,31(18):1635-1638.
[12]张玉洁.目标性心理护理应用于恶性肿瘤术后化疗患者护理中的临床效果观察[J].中国实用医药,2016,11(24):218-219.
[13]梁寅寅,甘秀妮,王玉琼,等.延续护理在癌痛患者中的应用现状及思考[J].中国实用护理杂志,2015,31(33):2502-2505.
[14]王永明.适应模式在骨转移瘤护理中的应用[J].国外医学(护理学分册),2002,21(2):85-86.
[15]周爱华.骨转移瘤放疗后应用安慰护理的临床观察[J].中国美容医学,2012,21(14):438-439.
[16]李爱敏,李宁,李治,等.骨转移瘤放疗止痛的护理干预[J].医学信息,2014,27(20):344-345
[17]李皎宁.骨转移瘤患者的护理[J].海军总医院学报,2007,20(4):248-250.
[18]林玲,潘明治.66例骨转移瘤放疗的护理[J].中国实用医药,2009,4(36):210.
[19]顾冬梅.护理程序在肿瘤患者疼痛管理中的实施体会[J].护理学报,2012,19(14):44-45.
[20]杨月.恶性肿瘤晚期骨转移疼痛护理[J].中外医疗,2011,30(24):168.