肺癌脑转移瘤患者伽玛刀治疗前焦虑危险因素和护理对策
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- 论文作者：赵莉 ; 汤可 ; 俞建臣 ; 赵亚群 ; 高冬晓 ; 高浩
- 年：2016
- 作者机构：中国人民解放军第三0九医院神经外科;
- 论文关键词：脑转移瘤 ; 心理 ; 焦虑 ; 护理 ; 影响因素
- 英文论文关键词：brain metastases ; psychology ; anxiety ; nursing ; predictor
- 会议召开时间：2016-11-25
- 会议录名称：湖南中医药大学学报2016/专集：国际数字医学会数字中医药分会成立大会暨首届数字中医药学术交流会论文集
- 语种：中文
- 分类号：R473.73
- 学会代码：HNZY
- 会议名称：国际数字医学会数字中医药分会成立大会暨首届数字中医药学术交流会
- 会议地点：中国广东珠海
- 主办单位：国际数字医学会、Digital Chinese Medicine
- 学会名称：湖南中医药大学期刊杂志社
- 页数：2
- 文件大小：2025k
- 原文格式：D
- 会议级别：全国
摘要
目的分析肺癌脑转移瘤患者伽玛刀治疗前焦虑的危险因素,探讨护理对策。方法回顾性分析肺癌脑转移瘤采取伽玛刀治疗患者的病历资料,将年龄、性别、学历、医疗保险、住院前检查时间、知情、肺癌病理类型,转移瘤大小、转移瘤数目、额叶病灶、激素治疗、是否颅外转移等列为影响因素,通过Hamilton汉密尔顿焦虑量表(HAMA)评定患者心理状况,采用卡方检验对影响因素与患者焦虑的关系进行单因素分析。采用非条件Logistic回归多因素分析明确患者焦虑的独立危险因素。结果本组术前HAMA评估结果显示:≥14分36例(28.57%),<14分90例(71.43%)。Pearson卡方检验显示年龄、医疗保险、知情、额叶病灶和是否颅外转移等等因素对对肺癌脑转移瘤患者伽玛刀治疗前发生焦虑的影响差异有统计学意义,非条件Logistic回归多因素分析显示医疗保险、额叶病灶和是否颅外转移等是发生焦虑的独立危险因素。结论完善医疗保障制度有助于缓解肿瘤患者焦虑情绪。对于位于额叶以及合并其他部位转移灶的肺癌脑转移瘤患者应加强心理关怀和疏导。
Objective To analyze the risk predictors of anxiety for patients with brain metastases of pulmonary cancer before Gamma Knife and discuss the nursing countermeasures. MethodsThe recordings of patients with brain metastases of pulmonary cancer undergoing Gamma Knife were retrospectively. Age, gender, education, medicare, duration of prehospital examination, informing, pathological type, size, quantity, lesion in frontal lobe, dexamethasone and extracranial metastases were analyzed as predictors. Psychologic status was evaluated by Hamilton anxiety rating scale(HAMA), and factors. Non-condition logistic regression analysis was employed to define the independent risk factors. Results The evaluation of preoperative HAMA show there were 36 cases(28.57%) withscore ≥ 14 and 90 cases(71.43%) with score < 14. Age, medicare, informing, lesion in frontal lobe and extracranial metastases et al were revealed as the factors significantly related to anxiety beforetreatment by Pearson chi-square test. Then, medicare, lesion in frontal lobe and extracranial metastases et al were shown as independent predictors for anxiety by the regression analysis. ConclusionEfforts should be done to improve medicare for anxiety relieving. Psychological care and intervention can be performed for patients with brain metastases of pulmonary cancer who have lesion in frontallobe and suffer extracranial metastases.
Objective To analyze the risk predictors of anxiety for patients with brain metastases of pulmonary cancer before Gamma Knife and discuss the nursing countermeasures. MethodsThe recordings of patients with brain metastases of pulmonary cancer undergoing Gamma Knife were retrospectively. Age, gender, education, medicare, duration of prehospital examination, informing, pathological type, size, quantity, lesion in frontal lobe, dexamethasone and extracranial metastases were analyzed as predictors. Psychologic status was evaluated by Hamilton anxiety rating scale(HAMA), and factors. Non-condition logistic regression analysis was employed to define the independent risk factors. Results The evaluation of preoperative HAMA show there were 36 cases(28.57%) withscore ≥ 14 and 90 cases(71.43%) with score < 14. Age, medicare, informing, lesion in frontal lobe and extracranial metastases et al were revealed as the factors significantly related to anxiety beforetreatment by Pearson chi-square test. Then, medicare, lesion in frontal lobe and extracranial metastases et al were shown as independent predictors for anxiety by the regression analysis. ConclusionEfforts should be done to improve medicare for anxiety relieving. Psychological care and intervention can be performed for patients with brain metastases of pulmonary cancer who have lesion in frontallobe and suffer extracranial metastases.
引文
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[2]Kitamura C,Ng D,Chung A,et al.Development and evaluation of a combined story and factbased educational booklet for patients with multiple brain metastases and their caregivers[J].Palliat Med.2011,25(6):642-649.
[3]Chow E,Fan G,Hadi S,et al.Symptom clusters in cancer patients with brain metastases[J].Clin Oncol(R Coll Radiol).2008,20(1):76-82.
[4]De Iuliis F,Salerno G,Taglieri L,et al.Elderly woman with triple-negative metastatic breast cancer successfully treated with metronomic capecitabine[J].Anticancer Res.2014,34(8):4287-4291.
[5]Berghoff AS,Sax C,Klein M,et al.Alleviation of brain edema and restoration of functional independence by bevacizumab in brain-metastatic breast cancer:a case report[J].Breast Care(Basel).2014,9(2):134-136.
[6]Stanley J,Dunscombe P,Lau H,et al.The effect of contouring variability on dosimetric parameters for brain metastases treated with stereotactic radiosurgery Int J Radiat Oncol Biol Phys.2013 Dec 1;87(5):924-31.
[7]Lin NU,Wefel JS,Lee EQ,et al.Challenges relating to solid tumour brain metastases in clinical trials,part 2:neurocognitive,neurological,and quality-of-life outcomes.A report from the RANO group[J].Lancet Oncol.2013,14(10):e407-e416.