乳腺癌新辅助和辅助化疗中植入式静脉港的应用与护理  

Application and nursing of implantable vascular access devices port during neoadjuvant and adjuvant chemotherapy in breast cancer

作　　者：司会丽 陈代娣[1] 苏莹 杨文谨 李晓雯 吴海滨[1] SI Hui-li;CHEN Dai-di;SU Ying;YANG Wen-jin;LI Xiao-wen;WU Hai-bin(Department of Breast Surgery,The First Affiliated Hospital of Henan University,Kaifeng 475001,China)

机构地区：[1]河南大学第一附属医院乳腺外科,河南开封475001

出　　处：《社区医学杂志》2022年第19期1107-1110,共4页Journal Of Community Medicine

基　　金：河南省医学科技攻关联合共建项目(LHGJ20190513)

摘　　要：目的对比乳腺癌新辅助化疗和辅助化疗期间植入式静脉输液港的并发症发生率及使用满意度,并探讨相关护理措施。方法选取2016-10-01-2021-09-30河南大学第一附属医院乳腺外科收治入院的70例颈内静脉植入胸壁静脉港的乳腺癌化疗患者,其中新辅助化疗静脉港患者34例,辅助化疗静脉港患者36例。采用秩和检验对比2组静脉港使用过程中并发症的发生率,并通过健康状况调查问卷(SF-36)进行生活质量评估。结果新辅助化疗组静脉港并发症5例,发生率为14.70%,术后辅助化疗组并发症6例,发生率为16.67%,2组比较,差异无统计学意义,χ^(2)=0.077,P=0.782。生活质量调查结果显示,术后辅助化疗静脉港患者的生理职能评分为25.0(0,70.0)分,低于新辅助化疗的75.0(75.0,100.0)分,差异有统计学意义,Z=-2.655,P=0.008;精神健康评分为36.0(24.0,56.0)分,低于新辅助化疗的80.0(64.0,92.0)分,差异有统计学意义,Z=-2.942,P=0.003;2组生理机能(Z=-0.688,P=0.492)、躯体疼痛(Z=-0.397,P=0.691)、一般健康(Z=0.907,P=0.364)、精力(Z=-0.313,P=0.753)、社会功能(Z=-0.198,P=0.843)和情感职能(Z=-0.035,P=0.971)比较,差异无统计学意义。结论植入式胸壁静脉港在新辅和辅助化疗过程中总体并发症发生率一致,但术后辅助化疗患者对其应用满意度较低,主要体现在佩戴舒适性和美观性等方面,护理工作中应注重心理疏导和沟通工作,必要时可选择其他入路。Objective To compare the incidence of complications and satisfaction with the use of implantable vascular access devices port(IVAP)during neoadjuvant chemotherapy and adjuvant chemotherapy for breast cancer,and to explore relevant nursing measures.Methods From October 1,2016 to September 30,2021,70 chemotherapy patients admitted to the breast surgery department of the First Affiliated Hospital of Henan University with breast cancer who received IVAP through the internal jugular vein were selected,including 34 patients in the neoadjuvant group and 36 patients in the postoperative group.Rank sum test was used to compare the incidence of complications during the use of IVAP between the two groups,and the 36-item short-form(SF-36)scale was further used to evaluate the quality of life of the patients.Results There were 5 venous port complications in the neoadjuvant chemotherapy group(14.70%),and 6 complications in the postoperative adjuvant chemotherapy group(16.67%),there was no significant difference between the two groups,χ^(2)=0.077,P=0.782.The results of quality of life survey showed that the physiological function score of patients with IVAP of adjuvant chemotherapy after surgery was 25.0(0,70.0),which was lower than 75.0(75.0,100.0)of patients with neoadjuvant chemotherapy,with a statistically significant difference(Z=-2.655,P=0.008).The mental health score of adjuvant chemotherapy after surgery was 36.0(24.0,56.0),which was lower than 80.0(64.0,92.0)of neoadjuvant chemotherapy,the difference was statistically significant(Z=-2.942,P=0.003).There was no significant difference between the two groups in physiological function(Z=-0.688,P=0.492),somatic pain(Z=-0.397,P=0.691),general health(Z=0.907,P=0.364),energy(Z=-0.313,P=0.753),social function(Z=-0.198,P=0.843)and emotional function(Z=-0.035,P=0.971).Conclusions The overall complication rate of IVAP during neoadjuvant and adjuvant chemotherapy is the same,but the postoperative patients were less satisfied with the comfort and beauty of the IVAP.Humanistic care

关 键 词：植入式静脉港 乳腺癌 并发症 护理 

分 类 号：R473.73[医药卫生—护理学]