聚乙二醇化重组人粒细胞刺激因子对乳腺癌化疗患者舒适度及护理的影响
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摘要
目的:评价聚乙二醇化重组人粒细胞刺激因子注射液(新瑞白,PEG-GCSF)应用于乳腺癌化疗对患者舒适度及护理的影响。方法:回顾性分析2016年3月至2017年9月在浙江省肿瘤医院行乳腺癌含蒽环联合紫衫方案化疗的100例患者的临床资料,一组使用重组人粒细胞刺激因子(GCSF)共44例,一组使用PEG-GCSF共56例。比较2组药物反应、舒适度评分、抽血次数、护理次数、护理时间。结果:PEG-GCSF组在疼痛平均评分、人均失眠、精神不佳及消化道症状出现次数上均明显小于GCSF组(P <0. 05);在舒适度方面PEG-GCSF组总评分显著高于GCSF组,且PEG-GCSF组在舒适度的生理、精神心理、社会及环境舒适均优于GCSF(P <0. 05); PEG-GCSF组平均抽血次数、单日人均护理次数、人均单次护理时间均显著低于GCSF组(P <0. 05);结论:乳腺癌化疗后应用PEG-GCSF可明显提高患者的舒适度且可减少护理次数与护理时间,减轻护理工作的压力。
[Objective]To evaluate the influences of PEGylated recombinant human granulocyte-stimulating factor injection( Xinrubai,PEG-GCSF) on breast cancer chemotherapy to patients' comfort and care. [Method]The clinical data of 100 patients with breast cancer including anthracene ring combined with purple shirt chemotherapy in Zhejiang cancer hospital from March 2016 to September 2017 were retrospectively analyzed. A group of 44 cases were used Recombinant Human Granulocyte Colony-stimulating Factor( GCSF) and a group of 56 cases were treated with PEG-GCSF. The indicators included adverse reaction,comfort score,blood routine number/cycle/number,frequency of care/person/day,nursing time/times/person. [Result]PEG-GCSF group was significantly less than GCSF group in average pain score,per capita insomnia,mental retardation and gastrointestinal symptoms. The total score of group PEG-GCSF in PEG-GCSF group was significantly higher than that of group GCSF( 17. 2),and the PEG-GCSF group was in the physiological and mental psychology of the comfort degree. The social and environmental comfort is better than GCSF( P < 0. 05). The average number of blood sampling times was 1. 3 times in group PEG-GCSF,16. 4 times per day per capita and 7. 6 min per person,which was significantly lower than that in group GCSF( P < 0. 05). [Conclusion]The application of PEG-GCSF after breast cancer chemotherapy can significantly improve the patient's comfort and reduce the number of treatments and nursing time,reducing the pressure of nursing work.
[Objective]To evaluate the influences of PEGylated recombinant human granulocyte-stimulating factor injection( Xinrubai,PEG-GCSF) on breast cancer chemotherapy to patients' comfort and care. [Method]The clinical data of 100 patients with breast cancer including anthracene ring combined with purple shirt chemotherapy in Zhejiang cancer hospital from March 2016 to September 2017 were retrospectively analyzed. A group of 44 cases were used Recombinant Human Granulocyte Colony-stimulating Factor( GCSF) and a group of 56 cases were treated with PEG-GCSF. The indicators included adverse reaction,comfort score,blood routine number/cycle/number,frequency of care/person/day,nursing time/times/person. [Result]PEG-GCSF group was significantly less than GCSF group in average pain score,per capita insomnia,mental retardation and gastrointestinal symptoms. The total score of group PEG-GCSF in PEG-GCSF group was significantly higher than that of group GCSF( 17. 2),and the PEG-GCSF group was in the physiological and mental psychology of the comfort degree. The social and environmental comfort is better than GCSF( P < 0. 05). The average number of blood sampling times was 1. 3 times in group PEG-GCSF,16. 4 times per day per capita and 7. 6 min per person,which was significantly lower than that in group GCSF( P < 0. 05). [Conclusion]The application of PEG-GCSF after breast cancer chemotherapy can significantly improve the patient's comfort and reduce the number of treatments and nursing time,reducing the pressure of nursing work.
引文
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[10]马军,朱军,徐兵河,等.聚乙二醇化重组人粒细胞刺激因子(PEG-rh G-CSF)临床应用中国专家共识[J].中国肿瘤临床,2016,43(7):271-274.
[11]Yang B B,Kido M A,Ms M M S,et al. Pharmacokinetics and Pharmacodynamics of Pegfilgrastim in Subjects With Various Degrees of Renal Function[J]. Clinical Pharmacokinetics,2008,48(9):1025-31.
[12]李娇,张晟,张瑾.重组人粒细胞集落刺激因子预防乳腺癌化疗后骨髓抑制的疗效分析[J].中国癌症杂志,2014,24(12):925-930.
[2]Dinan MA,Hirsch BR,Lyman GH. Management of che-motherapy-induced neutropenia:measuring quality,cost,and value[J]. J Natl Compr Canc Netw,2015,13(1):e1-e7.
[3]陈军,李杨,陈涛,等.聚乙二醇重组人粒细胞集落刺激因子预防乳腺癌化疗中性粒细胞减少的临床应用体会[J].中国保健营养,2016,11(下):8.
[4]孟如芬.传染病病人舒适度调查与护理对策[J].中国实用护理杂志,2005,21(3):18-19.
[5]张景龙.护理学基础[M].北京:人民卫生出版社,2000:110.
[6]叶萍,王红丽,余静,等.舒适护理在60例老年食管癌患者术后的应用[J].实用全科医学,2008,6(3):326-327.
[7]张瑾,陈薇,刘蕾. 2017年《NCCN乳腺癌筛查和诊断临床实践指南》(第1版)更新与解读[J].中国全科医学,2017,20(24):2039-2943.
[8]房文通,戴惠珍,陶琳,等.疼痛规范化治疗开展后南京地区非静脉阿片类镇痛药应用分析[J].中国疼痛医学杂志,2016,22(8):632-634.
[9]黄桂玲,孟宪梅,王雅丽.中文版舒适量表用于膝关节置换术后患者舒适评价[J].护理学杂志,2013,28(18):30-32.
[10]马军,朱军,徐兵河,等.聚乙二醇化重组人粒细胞刺激因子(PEG-rh G-CSF)临床应用中国专家共识[J].中国肿瘤临床,2016,43(7):271-274.
[11]Yang B B,Kido M A,Ms M M S,et al. Pharmacokinetics and Pharmacodynamics of Pegfilgrastim in Subjects With Various Degrees of Renal Function[J]. Clinical Pharmacokinetics,2008,48(9):1025-31.
[12]李娇,张晟,张瑾.重组人粒细胞集落刺激因子预防乳腺癌化疗后骨髓抑制的疗效分析[J].中国癌症杂志,2014,24(12):925-930.