喉癌术后患者延续性护理的研究进展
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摘要
喉癌是头颈部肿瘤中常见的恶性肿瘤,近年来该病的发病率略呈上升趋势。手术是喉癌患者的主要治疗方法之一,术后出院的患者,往往需要长期乃至终身的治疗和护理。延续性护理是针对出院患者的实际需求而提供的一种连续性、可靠性、安全性的医疗保健服务,通常包括患者回归家庭或社区后的持续随访与指导。对喉癌患者实施延续性护理干预,可能是帮助患者适应术后功能变化,预防并发症和提高生活质量的有效策略。本综述首先从"喉癌术后的特殊生理心理改变需要延续性护理、社会对延续性护理的发展提出了明确的要求"两方面阐述了喉癌术后患者实施延续性护理的必要性;其次从"喉癌术后患者延续性护理的主要内容及主要方式"两方面总结了国内外喉癌术后患者实施延续性护理的现状,并对实施的效果评价进行了清楚的展示;最后,本文通过对喉癌术后患者的延续性护理进行综合的评价,指出了现如今在实施过程中存在的不足,剖析出国内外目前针对喉癌延续性护理研究比较少的两点原因,一是患者的护理需求得不到充分表达;二是喉癌患者出院后延续性护理的内容广泛,专业性强,操作复杂,实施耗费大量的人力物力。这些分析便于指导医护人员结合我国的医疗现状和国外先进经验,积极开展相关研究,以期在未来可以进一步提高喉癌患者的生活质量。
Laryngeal cancer is a common malignant tumor in head and neck tumors,with increasing morbidity in recent years. Surgery is one of the main treatment methods for patients with laryngeal cancer,and patients who are discharged after surgery often need long-term and life-long treatment and care. Transitional care aims for the needs of discharged patients providing health care services with continuity,reliability,security,usually including continuous follow-up and guidance for patients after returning to the family or community. Transitional care after discharge may be an effective strategy to help patients with laryngeal cancer adapt to postoperative functional changes,prevent complications and improve their quality of life. This review starts from " continuity care for special physiological and psychological changes of postoperative laryngeal cancer,and social development putting forward clear requirements for continuity of care" two aspects this paper expounds the necessity of postoperative patients with laryngeal cancer implementation of continuity of care; followed by " the postoperative patients with laryngeal cancer continuity of care" the main content and main ways both postoperative patients with laryngeal cancer were summarized the present situation of the continuity of care,and to assess the effect on the implementation of the clear display; finally,based on the comprehensive evaluation on the continuity of the postoperative patients with laryngeal cancer care,it points out the shortages existing in the implementation process,analyzes the domestic and foreign current study laryngeal cancer continuity care which is short,because the patient' s care needs are not being adequately express and patients with laryngeal cancer after discharge from the hospital have a wide range of content,professional,complex operation,and a large amount of manpower and material resources.These analyses helps to guide the medical staff to actively carry out relevant research based on health status in China and advanced experience abroad,in order to further improve the quality of life in patients with laryngeal cancer in the future.
Laryngeal cancer is a common malignant tumor in head and neck tumors,with increasing morbidity in recent years. Surgery is one of the main treatment methods for patients with laryngeal cancer,and patients who are discharged after surgery often need long-term and life-long treatment and care. Transitional care aims for the needs of discharged patients providing health care services with continuity,reliability,security,usually including continuous follow-up and guidance for patients after returning to the family or community. Transitional care after discharge may be an effective strategy to help patients with laryngeal cancer adapt to postoperative functional changes,prevent complications and improve their quality of life. This review starts from " continuity care for special physiological and psychological changes of postoperative laryngeal cancer,and social development putting forward clear requirements for continuity of care" two aspects this paper expounds the necessity of postoperative patients with laryngeal cancer implementation of continuity of care; followed by " the postoperative patients with laryngeal cancer continuity of care" the main content and main ways both postoperative patients with laryngeal cancer were summarized the present situation of the continuity of care,and to assess the effect on the implementation of the clear display; finally,based on the comprehensive evaluation on the continuity of the postoperative patients with laryngeal cancer care,it points out the shortages existing in the implementation process,analyzes the domestic and foreign current study laryngeal cancer continuity care which is short,because the patient' s care needs are not being adequately express and patients with laryngeal cancer after discharge from the hospital have a wide range of content,professional,complex operation,and a large amount of manpower and material resources.These analyses helps to guide the medical staff to actively carry out relevant research based on health status in China and advanced experience abroad,in order to further improve the quality of life in patients with laryngeal cancer in the future.
引文
[1]徐帅,范崇盛.显微支撑喉镜CO2激光治疗早期声门型喉癌临床疗效观察[J].中国耳鼻咽喉头颈外科,2017,24(7):379-380.
[2]刘家锋.不同手术方式治疗喉癌的预后研究[J].当代医学,2017,23(28):59-60.
[3]张军,张耀明,王正辉,等.草苁蓉多糖提取物诱导人喉癌Hep2细胞凋亡的实验研究[J].陕西医学杂志,2014,43(8):947-949.
[4]韦升利,刘吉祥,邢轶卓,等. CO2激光显微手术联合中药口服、布地奈德雾化吸人治疗喉癌前病变临床观察[J].山东医药,2015,55(27):46-48.
[5] SINGER S,DANKER H,GUNTINAS-LICHIUS O,et al. Quality of life before and after total laryngectomy:results of a multicenter prospective cohort study[J]. Head Neck,2014,36(3):359-368.
[6]夏艳,吴翠良.喉癌合并慢性支气管炎患者气道护理方法的探讨[J].实用临床医药杂志,2015,19(18):183-184.
[7]金逸,施雁,龚美芳,等.以慢性病患者为中心的延续性护理模式的实施与效果[J].中华护理杂志,2015,50(11):1388-1391.
[8] HASAN Z,DWIVEDI R C,GUNARATNE D A,et al. Systematic review and meta-analysis of the complications of salvage total laryngectomy[J]. EurJ Surg Oncol,2016,43(1):42-51.
[9]孙秀霞,丁元平,季民,等.喉癌患者喉部分切除术后感染调查研究[J].中华医院感染学杂志,2015,25(21):4962-4964.
[10]谢月莲.喉癌术后并发症的原因分析及护理对策[J].基层医学论,2014,18(3):330-331.
[11]刘晓宙,胡国华.喉癌治疗对甲状腺功能的影响研究现状[J].现代医药卫生,2015,31(18):2778-2780.
[12]刘晨,李培华,许学谷,等.喉癌术后发生咽瘘的相关因素分析[J].徐州医学院学报,2016,36(9):606-607.
[13] BATIOˇGLU-KARAALTIN A,BINBAY Z,YIˇGIT,et al. Evaluation of life quality,self-confidence and sexual functions in patients with total and partial laryngectomy[J]. Auris Nasus Larynx,2017,44(2):188-194.
[14]辜德英,周琦,代黎.喉癌喉切除术后患者并发精神障碍的相关因素分析及护理对策[J].华西医学,2015,30(6):1127-1129.
[15]王庆华,于海腾.老龄化视角下医护养社区构建策略[J].齐鲁护理杂志,2015,21(5):55-56.
[16]张树云,倪婷.头颈部放疗患者的延续性康复护理[J].现代医药卫生,2017,33(4):588-590.
[17]肖欢,黄利华.延伸护理对喉癌术后患者生活质量的影响[J].医学临床研究,2014,31(8):1658-1659.
[18]薛莎,姚爱琴.全喉切除术患者施行延续性护理的价值评析[J].中外女性健康研究,2016(5):100.
[19]潘延林,曹菲,李佩忠.护患微信群在喉癌术后患者延续护理服务中的应用[J].现代医学,2016,44(9):1203-1206.
[20]赵梅君,周英,杨从艳,等.延续性护理模式对喉癌患者术后癌因性疲乏及生活质量的影响[J].中华全科医学,2017,11(15):1981-1983.
[21]杨晓燕,张军华,向白璐,等. QQ群平台延续护理对喉癌全切出院患者自护知识掌握和遵医行为的影响[J].当代护士,2016(5):116-117.
[22]高莲英,李娜.多学科合作团队干预模式对喉癌患者术后自我护理能力的影响[J].齐鲁护理杂志,2015,21(14):25-27.
[23] Badran K W,Heineman T E,Kuan E C,et al. Is multidisciplinary team care for head and neck cancer worth it?[J]. Laryngoscope,2018,128(6):1257-1258.
[24]王丽丹,庄燕.多学科团队护理模式对改善喉癌患者术后自我护理能力和生活质量的效果[J].当代护士,2016,3:73-75.
[25]归纯漪,薛一帆,葛向煜,等.利用最佳证据规范全喉切除术后患者出院照护计划[J].护士进修杂志,2015,30(11):1038-1041.
[26] CLEMENT Z. Role of discharge planning in avoiding rehospitalisation in an aboriginal man following head and neck surgery:a case report[J]. Aboriginal&Islander Health Worker Journal,2011,35(2):20-22.
[27] SUNDBERG K,EKLOF A L,BLOMBERG K,et al. Feasibility of an interactive ICT-platform for early assessment and management of patient-reported symptoms during radiotherapy for prostate cancer[J].Eur J Oncol Nurs,2015,19(5):523-528.
[28] BUDIN W,ROLNITZKY L,FORMENTI S,et al. Optimal topical agent for radiation dermatitis during breast radio therapy:A pilot study[J]. Cli J Oncol Nurs,2015,9(4):451-455.
[29] CNOSSEN I C,VAN UDEN-KRAAN C F,EERENSTEIN S E,et al.An online self-care education program to support patients after total laryngectomy:feasibility and satisfaction[J]. Support Care Cancer,2016,24(3):1261-1268.
[30]张少红,陈伯峰,曾丽梅,等.基于即时通讯技术的延续性护理对脑卒中失语症病人生活质量的影响[J].全科护理,2017,15(29):3652-3654.
[31]张蕾,郭素萍.基于微信的延续性护理在肿瘤化疗患者全程护理中的应用[J].实用临床医药杂志,2017,21(22):113-114.
[32] OLDHAM J. Patient comment:hospitalisation among patients with diabetes associated with a diabetes integrated care initiative:a mixed methods case study[J]. Future Hosp J,2015,2(2):100-101.
[33]杨晓燕,向丽华.喉癌术后患者医院-社区-家庭一体化照顾模式的构建与实施[J].当代护士,2016(9):70-72.
[34] BEUDAERT M,HOUZE S,PIESYK V,et al. Hospital care in the home after a laryngectomy[J]. Rev Infirm,2013,193(193):27-28.
[35] FEBER T. Tracheostomy care for community nurses:basic principles[J]. Br J Community Nurs,2016,11(5):186-193.
[36] JANSSENS G O,LANGENDIJK J A,TERHAARD C H,et al. Quality-of-life after radiotherapy for advanced laryngeal cancer:results of a phaseⅢtrial of the dutch head and neck society[J]. Radiotherapy and Oncology,2016,2(23):1-8.
[37]李灶容,张金蓉,林凤娟.延续护理提高喉癌患者术后生存质量的效果评价[J].吉林医学,2015,36(11):2374-2375.
[38]张丹,张惠荣.个性化延续护理方式对喉癌切除出院患者生活质量的影响[J].实用临床护理学电子杂志,2017,2(21):147-148.
[39]钟典,王雪芬.延续性护理对喉癌全喉切除术老年患者生活质量的影响[J].职业与健康,2014,30(10):1423-1424.
[40]李国红.延续性护理干预对喉癌患者术后生存质量及不良情绪的影响研究[J].中国全科医学,2016,19(S1):464-466.
[41]彭亚如.延续性护理用于喉癌患者术后对其生活质量的影响评价[J].大家健康,2016,10(7):230-231.
[42]杨彩虹,颜少观.延续性护理在喉癌术后出院随访中的应用[J].中国卫生标准管理,2017,8(8):186-188.
[43]鲍学英,陈家琳,樊兵.延续护理对喉癌患者术后生存质量及心理状态的影响[J].中外医疗,2016,35(13):151-153.
[44]诸燕芳.延续护理对喉癌患者术后生存质量及心理状态的影响[J].母婴世界,2017(9):211.
[45] TOWNSLEY R B,BARING D E,CLARK L J,et al. Emergency department care of a patient after a total laryngectomy[J]. Eur J Emerg Med,2014,21(3):164-169.
[2]刘家锋.不同手术方式治疗喉癌的预后研究[J].当代医学,2017,23(28):59-60.
[3]张军,张耀明,王正辉,等.草苁蓉多糖提取物诱导人喉癌Hep2细胞凋亡的实验研究[J].陕西医学杂志,2014,43(8):947-949.
[4]韦升利,刘吉祥,邢轶卓,等. CO2激光显微手术联合中药口服、布地奈德雾化吸人治疗喉癌前病变临床观察[J].山东医药,2015,55(27):46-48.
[5] SINGER S,DANKER H,GUNTINAS-LICHIUS O,et al. Quality of life before and after total laryngectomy:results of a multicenter prospective cohort study[J]. Head Neck,2014,36(3):359-368.
[6]夏艳,吴翠良.喉癌合并慢性支气管炎患者气道护理方法的探讨[J].实用临床医药杂志,2015,19(18):183-184.
[7]金逸,施雁,龚美芳,等.以慢性病患者为中心的延续性护理模式的实施与效果[J].中华护理杂志,2015,50(11):1388-1391.
[8] HASAN Z,DWIVEDI R C,GUNARATNE D A,et al. Systematic review and meta-analysis of the complications of salvage total laryngectomy[J]. EurJ Surg Oncol,2016,43(1):42-51.
[9]孙秀霞,丁元平,季民,等.喉癌患者喉部分切除术后感染调查研究[J].中华医院感染学杂志,2015,25(21):4962-4964.
[10]谢月莲.喉癌术后并发症的原因分析及护理对策[J].基层医学论,2014,18(3):330-331.
[11]刘晓宙,胡国华.喉癌治疗对甲状腺功能的影响研究现状[J].现代医药卫生,2015,31(18):2778-2780.
[12]刘晨,李培华,许学谷,等.喉癌术后发生咽瘘的相关因素分析[J].徐州医学院学报,2016,36(9):606-607.
[13] BATIOˇGLU-KARAALTIN A,BINBAY Z,YIˇGIT,et al. Evaluation of life quality,self-confidence and sexual functions in patients with total and partial laryngectomy[J]. Auris Nasus Larynx,2017,44(2):188-194.
[14]辜德英,周琦,代黎.喉癌喉切除术后患者并发精神障碍的相关因素分析及护理对策[J].华西医学,2015,30(6):1127-1129.
[15]王庆华,于海腾.老龄化视角下医护养社区构建策略[J].齐鲁护理杂志,2015,21(5):55-56.
[16]张树云,倪婷.头颈部放疗患者的延续性康复护理[J].现代医药卫生,2017,33(4):588-590.
[17]肖欢,黄利华.延伸护理对喉癌术后患者生活质量的影响[J].医学临床研究,2014,31(8):1658-1659.
[18]薛莎,姚爱琴.全喉切除术患者施行延续性护理的价值评析[J].中外女性健康研究,2016(5):100.
[19]潘延林,曹菲,李佩忠.护患微信群在喉癌术后患者延续护理服务中的应用[J].现代医学,2016,44(9):1203-1206.
[20]赵梅君,周英,杨从艳,等.延续性护理模式对喉癌患者术后癌因性疲乏及生活质量的影响[J].中华全科医学,2017,11(15):1981-1983.
[21]杨晓燕,张军华,向白璐,等. QQ群平台延续护理对喉癌全切出院患者自护知识掌握和遵医行为的影响[J].当代护士,2016(5):116-117.
[22]高莲英,李娜.多学科合作团队干预模式对喉癌患者术后自我护理能力的影响[J].齐鲁护理杂志,2015,21(14):25-27.
[23] Badran K W,Heineman T E,Kuan E C,et al. Is multidisciplinary team care for head and neck cancer worth it?[J]. Laryngoscope,2018,128(6):1257-1258.
[24]王丽丹,庄燕.多学科团队护理模式对改善喉癌患者术后自我护理能力和生活质量的效果[J].当代护士,2016,3:73-75.
[25]归纯漪,薛一帆,葛向煜,等.利用最佳证据规范全喉切除术后患者出院照护计划[J].护士进修杂志,2015,30(11):1038-1041.
[26] CLEMENT Z. Role of discharge planning in avoiding rehospitalisation in an aboriginal man following head and neck surgery:a case report[J]. Aboriginal&Islander Health Worker Journal,2011,35(2):20-22.
[27] SUNDBERG K,EKLOF A L,BLOMBERG K,et al. Feasibility of an interactive ICT-platform for early assessment and management of patient-reported symptoms during radiotherapy for prostate cancer[J].Eur J Oncol Nurs,2015,19(5):523-528.
[28] BUDIN W,ROLNITZKY L,FORMENTI S,et al. Optimal topical agent for radiation dermatitis during breast radio therapy:A pilot study[J]. Cli J Oncol Nurs,2015,9(4):451-455.
[29] CNOSSEN I C,VAN UDEN-KRAAN C F,EERENSTEIN S E,et al.An online self-care education program to support patients after total laryngectomy:feasibility and satisfaction[J]. Support Care Cancer,2016,24(3):1261-1268.
[30]张少红,陈伯峰,曾丽梅,等.基于即时通讯技术的延续性护理对脑卒中失语症病人生活质量的影响[J].全科护理,2017,15(29):3652-3654.
[31]张蕾,郭素萍.基于微信的延续性护理在肿瘤化疗患者全程护理中的应用[J].实用临床医药杂志,2017,21(22):113-114.
[32] OLDHAM J. Patient comment:hospitalisation among patients with diabetes associated with a diabetes integrated care initiative:a mixed methods case study[J]. Future Hosp J,2015,2(2):100-101.
[33]杨晓燕,向丽华.喉癌术后患者医院-社区-家庭一体化照顾模式的构建与实施[J].当代护士,2016(9):70-72.
[34] BEUDAERT M,HOUZE S,PIESYK V,et al. Hospital care in the home after a laryngectomy[J]. Rev Infirm,2013,193(193):27-28.
[35] FEBER T. Tracheostomy care for community nurses:basic principles[J]. Br J Community Nurs,2016,11(5):186-193.
[36] JANSSENS G O,LANGENDIJK J A,TERHAARD C H,et al. Quality-of-life after radiotherapy for advanced laryngeal cancer:results of a phaseⅢtrial of the dutch head and neck society[J]. Radiotherapy and Oncology,2016,2(23):1-8.
[37]李灶容,张金蓉,林凤娟.延续护理提高喉癌患者术后生存质量的效果评价[J].吉林医学,2015,36(11):2374-2375.
[38]张丹,张惠荣.个性化延续护理方式对喉癌切除出院患者生活质量的影响[J].实用临床护理学电子杂志,2017,2(21):147-148.
[39]钟典,王雪芬.延续性护理对喉癌全喉切除术老年患者生活质量的影响[J].职业与健康,2014,30(10):1423-1424.
[40]李国红.延续性护理干预对喉癌患者术后生存质量及不良情绪的影响研究[J].中国全科医学,2016,19(S1):464-466.
[41]彭亚如.延续性护理用于喉癌患者术后对其生活质量的影响评价[J].大家健康,2016,10(7):230-231.
[42]杨彩虹,颜少观.延续性护理在喉癌术后出院随访中的应用[J].中国卫生标准管理,2017,8(8):186-188.
[43]鲍学英,陈家琳,樊兵.延续护理对喉癌患者术后生存质量及心理状态的影响[J].中外医疗,2016,35(13):151-153.
[44]诸燕芳.延续护理对喉癌患者术后生存质量及心理状态的影响[J].母婴世界,2017(9):211.
[45] TOWNSLEY R B,BARING D E,CLARK L J,et al. Emergency department care of a patient after a total laryngectomy[J]. Eur J Emerg Med,2014,21(3):164-169.