三维适形放疗致放射性肝损伤79例循证护理效果观察  

Observation on the effect of evidence-based nursing care on 79 patients with liver injury induced by the three dimensional conformal radiotherapy

作　　者：陈静[1] 李玲[1] 葛文娥[2] 

机构地区：[1]无锡市第四人民医院,江苏无锡214062 [2]苏州大学第四临床医学院

出　　处：《齐鲁护理杂志》2011年第1期1-3,共3页Journal of Qilu Nursing

基　　金：江苏省社会发展科技计划指导项目(编号:BS2006504)

摘　　要：目的:探讨三维适形放疗(3DCRT)致原发性肝癌(PLC)患者放射性肝损伤(RILD)的循证护理效果。方法:将115例实施3DCRT治疗的PLC患者随机分为实验组79例和对照组36例,实验组依据3DCRT放射性肝损伤循证护理的实证制定和实施护理措施,对照组实施常规护理措施。结果:循证医学发现3DCRT的RILD发生危险因素分别为肝肿瘤体积(GTV)、T分期、肝硬化分级和门脉癌栓,其中肝硬化是影响RILD的独立预后因素。实验组RILD发生率为5.06%、对照组为16.67%,两组比较差异有统计学意义(P<0.01)。结论:围3DCRT期护理、保肝护理、营养饮食指导等循证护理和3DCRT技术的精确性、临床放疗剂量合理性、全肝20 Gy受照体积(V_(20))≤40%,可以降低肝细胞癌3DCRT放射性肝损伤的发生,提高PLC临床疗效。Objective ： To explore the effect of evidence - based nursing care on the primary liver cancer （ PLC ） patients with radiation -induced liver injury （RILD） caused by the three dimensional eonformal radiotherapy （3DCRT）. Methods： 115 PLC patients who received 3DCRT were randomly divided into experimental group （ n = 79） and control group （ n = 36）. The nursing measures were chosen and implemented according to the evidence - based nursing care in the experimental group and routine nursing care was taken in the control group. Results： Evidence - Based Medicine showed that the risk factors which caused RILD induced by 3DCRT were GTV, T stage, classification of cirrhosis and portal vein tumor thrombosis. Cirrhosis was the independent factor influencing the prognosis of RILD. The incidence of RILD was 5.06% and 16.67% in the experimental group and control group respectively, the difference between the two groups was statistically significant （P 〈 0.01 ）. Conclusion： Peri- 3DCRT nursing care, liver protective care, guidance on nutrition and dietary and other evidence -based nursing care, reasonable clinical radiotherapy dose, etc. can reduce the occurrence of RILD caused by 3DCRT and improve the clinical efficacy in the treatment of PLC.

关 键 词：肝细胞癌 放射治疗 循证护理 

分 类 号：R473.5[医药卫生—护理学]