护理干预在缓解鼻咽癌患者放疗致口腔黏膜反应的应用
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摘要
本研究将116例接受化疗的鼻咽癌患者根据随机数字表分为两组,其中,对照组予以常规护理,观察组予以护理干预。对比两组干预后的口腔黏膜损伤程度、疼痛程度及生活质量之后,发现观察组口腔黏膜损伤程度明显低于对照组,差异有统计学意义(W=1 254,p<0.05);观察组疼痛水平明显低于对照组,差异有统计学意义(W=1 755,p<0.05);两组干预后的SCL-90量表在焦虑、恐惧、抑郁、敌对和躯体化等5个方面的得分均有差异,观察组低于对照组(p<0.05)。提示护理干预能有效减轻鼻咽癌放疗口腔黏膜反应,减轻患者的痛苦,改善临床症状。
In this study, 116 cases of nasopharyngeal carcinoma patients treated by radiotherapy were divided into two groups according to the random number table, of which the control group was received routine nursing care while the observation group received additional nursing interventions. After contrasting the damage degree of the oral mucosa, degree of pain and quality of life of two groups after intervention, we found that the damage degree of the oral mucosa of observation group was obviously lower than that of the control group, and the difference was statistically significant(W=1 254, p<0.05). Morever, the pain degree of the observation group was obviously lower than that of the control group, and the difference was statistically significant(W =1 755, p <0.05). The Symptom Checklist 90 of the two groups after intervention had significant differences in the following 5 aspects:anxiety, fear, depression, hostility and somzatization, and values of the observation group were lower than those of the control group(p>0.05). In conclusion, nursing intervention had a remarkable effect on relieving oral mucosa reactions of nasopharyngeal carcinoma patients treated by radiotherapy, which could alleviate patient's suffering and improve the clinical symptoms.
In this study, 116 cases of nasopharyngeal carcinoma patients treated by radiotherapy were divided into two groups according to the random number table, of which the control group was received routine nursing care while the observation group received additional nursing interventions. After contrasting the damage degree of the oral mucosa, degree of pain and quality of life of two groups after intervention, we found that the damage degree of the oral mucosa of observation group was obviously lower than that of the control group, and the difference was statistically significant(W=1 254, p<0.05). Morever, the pain degree of the observation group was obviously lower than that of the control group, and the difference was statistically significant(W =1 755, p <0.05). The Symptom Checklist 90 of the two groups after intervention had significant differences in the following 5 aspects:anxiety, fear, depression, hostility and somzatization, and values of the observation group were lower than those of the control group(p>0.05). In conclusion, nursing intervention had a remarkable effect on relieving oral mucosa reactions of nasopharyngeal carcinoma patients treated by radiotherapy, which could alleviate patient's suffering and improve the clinical symptoms.
引文
Atchariyasathian V.,Pruegsanusak K.,and Wongsriwattanakul S2015,Sensorineural hearing loss following induction chemo therapy plus concurrent chemoradiotherapy for advanced na sopharyngeal carcinoma,J.Laryngol.Oto.l,129(8):767-772
Casanova M.,魻zyar E.,Patte C.,Orbach D.,Ferrari A.,VeyratFollet C.,Errihani H.,Pan J.,Zhang L.,Shen L.,Grze gorzewski K.J.,and Varan A.,2016,International random ized phase 2 study on the addition of docetaxel to the combi nation of cisplatin and 5-fluorouracil in the induction treat ment for nasopharyngeal carcinoma in children and adoles cents,Cancer Chemother Pharmacol.,77(2):289-298
Feng S.,Fan Y.,Liang Z.,Yang G.,Liao Z.,and Guo L.,2016Effect of intranasal steroids on rhinosinusitis after radiother apy for nasopharyngeal carcinoma:clinical study,J.Laryn gol.Otol.,130(3):265-271
He Q.,Huang Y.J.,Han Z.J.,Yan X.M.,and Cai Y.,2015Cloning,plasmid construction and expression of S100A8and S100A9 gene in nasopharyngeal carcinoma cells,Jiy inzuxue Yu Yingyong Shengwuxue(Genomics and Applied Biology),34(8):1594-1599(何芹,黄元姣,撖子建,鄢雪敏蔡琰,2015,鼻咽癌细胞中S100A8与S100A9基因的克隆及其质粒构建和表达,基因组学与应用生物学,34(8)1594-1599)
Hou J.,Yu X.,Hu Y.,Li F.,Xiang W.,Wang L.,Wang H.,Lu Q.Zhang Z.,and Zeng W.,2016,Value of intravoxel incoher ent motion and dynamic contrast-enhanced MRI for predict ing the early and short-term responses to chemoradiotherapy in nasopharyngeal carcinoma,Medicine(Baltimore),95(35)e4320
Komatsu M.,Arai Y.,Yabuki K.,Sano D.,Shiono O.,Sakuma Y.,Nishimura G.,Takahashi M.,Taguchi T.,and Oridate N.,2015,Concurrent chemoradiotherapy with docetaxel cisplatin and 5-fluorouracil(TPF)in patients with nasopha ryngeal carcinoma,Anticancer Res.,35(12):6861-6867
Li Y.,Pan K.,Liu L.Z.,Li Y.Q.,Gu M.F.,Zhang H.,Shen W.X.Xia J.C.,and Li J.J.,2015,Sequential cytokine-induced killer cell immunotherapy enhances the efficacy of the gem citabine plus cisplatin chemotherapy regimen for metastatic nasopharyngeal carcinoma,PLo S One,10(6):e0130620
Lian Y.F.,Yuan J.,Cui Q.,Feng Q.S.,Xu M.,Bei J.X.,Zeng YX.,and Feng L.,2016,Upregulation of KLHDC4 predicts a poor prognosis in human nasopharyngeal carcinoma,PLo SOne,11(3):e0152820
Liang Z.,Wang S.,Lin Z.,Feng S.,Cheng Z.,Yang Y.,Kuang Y.Fidelis C.,Ullah S.,and Li F.,2016,Phase I trial o nedaplatin chemotherapy concurrent with radiotherapy fo untreated locoregionally advanced nasopharyngeal carcino ma,Cancer Chemother Pharmacol,77(3):643-651
Lv X.,Xia W.X.,Ke L.R.,Yang J.,Qiu W.Z.,Yu Y.H.,Liang H.Huang X.J.,Liu G.Y.,Zeng Q.,Guo X.,and Xiang Y.Q.2016,Comparison of the short-term efficacy between doc etaxel plus carboplatin and 5-fluorouracil plus carboplatin in locoregionally advanced nasopharyngeal carcinoma,On co.Targets Ther.,18(9):5123-5131
Ou Yang P.Y.,Bi Z.F.,Zhang L.N.,You K.Y.,Xiao Y.,Lan X.WTang J.,Wang X.C.,Deng W.,and Xie F.Y.,2016,Outcome of induction chemotherapy plus intensity-modulated radio therapy(IMRT)versus IMRT plus concurrent chemothera py for locoregionally advanced nasopharyngeal carcinoma:propensity matched study,Transl.Oncol.,9(4):329-335
Shi R.C.,Meng A.F.,Zhou W.L.,Yu X.Y.,Huang X.E.,Ji A.J.and Chen L.,2015,Effects of home nursing intervention on the quality of life of patients with nasopharyngeal carcinoma after radiotherapy and chemotherapy,Asian Pac.J.Cance Prev.,16(16):7117-7121
Xu T.,Liu Y.,Dou S.,Li F.,Guan X.,and Zhu G.,2015,Weekly cetuximab concurrent with IMRT aggravated radiation-in duced oral mucositis in locally advanced nasopharyngea carcinoma:Results of a randomized phaseⅡstudy,Oral Oncol.,51(9):875-879
Zeng Q.,Wang J.,Lv X.,Li J.,Yin L.J.,Xiang Y.Q.,and Guo X.2016,Induction chemotherapy followed by radiotherapy versus concurrent chemoradiotherapy in elderly patient with nasopharyngeal carcinoma:finding from a propensi ty-matched analysis,BMC Cancer,30(16):693
Zhu H.H.,and Zhu X.Y.,2014,Relationship between cyclooxyge nase-2 in nasopharyngeal carcinoma and cervical lymph nod metastasis,Zhonghua Yixue Zazhi(National Medical Journa of China),94(18):1409-1412(朱洪海,朱晓远,2014,环氧化酶-2与鼻咽癌颈淋巴结转移的关系,中华医学杂志,94(18):1409-1412)
Casanova M.,魻zyar E.,Patte C.,Orbach D.,Ferrari A.,VeyratFollet C.,Errihani H.,Pan J.,Zhang L.,Shen L.,Grze gorzewski K.J.,and Varan A.,2016,International random ized phase 2 study on the addition of docetaxel to the combi nation of cisplatin and 5-fluorouracil in the induction treat ment for nasopharyngeal carcinoma in children and adoles cents,Cancer Chemother Pharmacol.,77(2):289-298
Feng S.,Fan Y.,Liang Z.,Yang G.,Liao Z.,and Guo L.,2016Effect of intranasal steroids on rhinosinusitis after radiother apy for nasopharyngeal carcinoma:clinical study,J.Laryn gol.Otol.,130(3):265-271
He Q.,Huang Y.J.,Han Z.J.,Yan X.M.,and Cai Y.,2015Cloning,plasmid construction and expression of S100A8and S100A9 gene in nasopharyngeal carcinoma cells,Jiy inzuxue Yu Yingyong Shengwuxue(Genomics and Applied Biology),34(8):1594-1599(何芹,黄元姣,撖子建,鄢雪敏蔡琰,2015,鼻咽癌细胞中S100A8与S100A9基因的克隆及其质粒构建和表达,基因组学与应用生物学,34(8)1594-1599)
Hou J.,Yu X.,Hu Y.,Li F.,Xiang W.,Wang L.,Wang H.,Lu Q.Zhang Z.,and Zeng W.,2016,Value of intravoxel incoher ent motion and dynamic contrast-enhanced MRI for predict ing the early and short-term responses to chemoradiotherapy in nasopharyngeal carcinoma,Medicine(Baltimore),95(35)e4320
Komatsu M.,Arai Y.,Yabuki K.,Sano D.,Shiono O.,Sakuma Y.,Nishimura G.,Takahashi M.,Taguchi T.,and Oridate N.,2015,Concurrent chemoradiotherapy with docetaxel cisplatin and 5-fluorouracil(TPF)in patients with nasopha ryngeal carcinoma,Anticancer Res.,35(12):6861-6867
Li Y.,Pan K.,Liu L.Z.,Li Y.Q.,Gu M.F.,Zhang H.,Shen W.X.Xia J.C.,and Li J.J.,2015,Sequential cytokine-induced killer cell immunotherapy enhances the efficacy of the gem citabine plus cisplatin chemotherapy regimen for metastatic nasopharyngeal carcinoma,PLo S One,10(6):e0130620
Lian Y.F.,Yuan J.,Cui Q.,Feng Q.S.,Xu M.,Bei J.X.,Zeng YX.,and Feng L.,2016,Upregulation of KLHDC4 predicts a poor prognosis in human nasopharyngeal carcinoma,PLo SOne,11(3):e0152820
Liang Z.,Wang S.,Lin Z.,Feng S.,Cheng Z.,Yang Y.,Kuang Y.Fidelis C.,Ullah S.,and Li F.,2016,Phase I trial o nedaplatin chemotherapy concurrent with radiotherapy fo untreated locoregionally advanced nasopharyngeal carcino ma,Cancer Chemother Pharmacol,77(3):643-651
Lv X.,Xia W.X.,Ke L.R.,Yang J.,Qiu W.Z.,Yu Y.H.,Liang H.Huang X.J.,Liu G.Y.,Zeng Q.,Guo X.,and Xiang Y.Q.2016,Comparison of the short-term efficacy between doc etaxel plus carboplatin and 5-fluorouracil plus carboplatin in locoregionally advanced nasopharyngeal carcinoma,On co.Targets Ther.,18(9):5123-5131
Ou Yang P.Y.,Bi Z.F.,Zhang L.N.,You K.Y.,Xiao Y.,Lan X.WTang J.,Wang X.C.,Deng W.,and Xie F.Y.,2016,Outcome of induction chemotherapy plus intensity-modulated radio therapy(IMRT)versus IMRT plus concurrent chemothera py for locoregionally advanced nasopharyngeal carcinoma:propensity matched study,Transl.Oncol.,9(4):329-335
Shi R.C.,Meng A.F.,Zhou W.L.,Yu X.Y.,Huang X.E.,Ji A.J.and Chen L.,2015,Effects of home nursing intervention on the quality of life of patients with nasopharyngeal carcinoma after radiotherapy and chemotherapy,Asian Pac.J.Cance Prev.,16(16):7117-7121
Xu T.,Liu Y.,Dou S.,Li F.,Guan X.,and Zhu G.,2015,Weekly cetuximab concurrent with IMRT aggravated radiation-in duced oral mucositis in locally advanced nasopharyngea carcinoma:Results of a randomized phaseⅡstudy,Oral Oncol.,51(9):875-879
Zeng Q.,Wang J.,Lv X.,Li J.,Yin L.J.,Xiang Y.Q.,and Guo X.2016,Induction chemotherapy followed by radiotherapy versus concurrent chemoradiotherapy in elderly patient with nasopharyngeal carcinoma:finding from a propensi ty-matched analysis,BMC Cancer,30(16):693
Zhu H.H.,and Zhu X.Y.,2014,Relationship between cyclooxyge nase-2 in nasopharyngeal carcinoma and cervical lymph nod metastasis,Zhonghua Yixue Zazhi(National Medical Journa of China),94(18):1409-1412(朱洪海,朱晓远,2014,环氧化酶-2与鼻咽癌颈淋巴结转移的关系,中华医学杂志,94(18):1409-1412)