长春瑞滨联合顺铂方案化疗时辰给药联合专项护理改善肺癌化疗患者预期性呕吐的效果  

Effect of hour administration and nursing on the predictability vomiting of lung cancer patients receiving the NP program

作　　者：兆天欣[1] 马锐[1] 王辉[1] 蒋丽[1] 

机构地区：[1]辽宁省肿瘤医院内四科,沈阳110042

出　　处：《中华现代护理杂志》2012年第25期3012-3015,共4页Chinese Journal of Modern Nursing

基　　金：辽宁省科技攻关项目资助项目（2011225019）

摘　　要：目的观察长春瑞滨联合顺铂（NP）方案化疗时辰给药及护理改善肺癌患者预期性呕吐（ANY）效果。方法2010年1月至2011年10月连续选取79例住院接受NP方案化疗的肺癌患者，按随机数字表分为时辰化疗组40例和常规化疗组39例。时辰化疗组采用PICC导管置管，方法为：长春瑞滨（NVB）25mg／（m2-d），17：00—03：00，峰值21：00，dl和d8给药；顺铂（PDD）20mg/（m2·d），10：00～22：00，峰值16：00，dl—d3给药。常规化疗组采用外周静脉输液给药，NVB25mg／（m2·d），dl和d8给药，PDD20mg／（m2·d），9：00～13：00，d1-d3给药。1个周期均为21d，接受2～4个周期的治疗。两组患者均接受肺癌化疗常规护理，时辰治疗组还另行专项护理（包括严格执行时辰用药医嘱、保持静脉置管通畅、进行床头交接班和进行睡眠护理干预等内容）。第2周期开始前，采用ANY等级指标和恶心问卷对两组患者预期性呕吐的情况进行评估。结果时辰化疗组患者的ANY发生率（22．50％）低于常规化疗组（58．97％），两组比较，差异有统计学意义（X2=10．847，P〈0．01）。时辰化疗组恶心问卷中总分（0．29±0．13）分、躯体不适因子得分（0．19±0．07）分、消化道反应因子得分（0．27±0．10）分及情绪痛苦因子得分（0．17±0．06）分，明显低于常规化疗组[（0．52±0．19），（0．32±0．11），（0．45±0．16），（0．28±0．12）分]，两组比较，差异有统计学意义（t分别为2．530，2．075，2．429，2．133；P〈0．05）。结论NP方案时辰给药联合专项护理方法可降低肺癌化疗患者ANY发生率、改善ANY等级指标及恶心问卷评分。Objective To observe the effect of hour administration and care on the predictability vomiting of lung cancer patients receiving the NP program. Methods Totals of 79 cases that received NP chemotherapy program were randomly divided into chrono-chemotherapy group （n = 40 ） and routine chemotherapy group （n = 39）. Chrono-chemotherapy group with PICC catheters received the vinorelbine （NVB） at the dose of 25 mg/（ m2 .d ） , in the time of 17 ： 00 to 03 ： 00 and with the peak 21 ： 00, dl and d8 administration; and cispiatin （PDD） at the dose of 20 mg/（ m2 - d）, the administration time was 10：00- 22：00 with 16：00 peak, dl-d3. The routine chemotherapy group with peripheral intravenous infusion received NVB at the dose of 25 mg/（m2.d） with dl and d8 administration, and PDD at 20 mg/（m2 . d） and administration in 9：00 - 13：00 and d1- d3. Two groups received 2 to 4 cycles treatment with 21 days of one cycle. And received the routine care of lung cancer chemotherapy, while the chrono-chemotherapy group also be special cared such as strictly perform the hour clinical medication advice, maintain intravenous catheter patency, bedside shift and sleep care intervention and so on. Before the start of second cycle, both groups were treated with ＂ANY level indicators＂ and ＂disgusting questionnaire （NP） assessment. Results The ANY incidence of chromo-chemotherapy group（22.5% ） was significantly less than that of routine chemotherapy group（58.97% ）. There were significant statistical different between the two group. In the chromo-chemotherapy group, the total score of nausea questionnaire （0.29±0. 13 vs 0.52±0.19）, body discomfort factor score （0.19 ±0.07 vs 0.32±0. 11 ） ,gastrointestinal reaction factor score （0.27±0. 10 vs 0.45 ±0.16）, emotional pain factor score （0.17±0.06 vs 0.28± 0. 12）, were significantly lower than that of routine chemotherapy group,and the difference was statistically significant （ t = 2. 530, 2. 075, 2. 429, 2. 133 ;

关 键 词：护理 肺肿瘤 抗肿瘤联合化疗方案 时间疗法 呕吐 

分 类 号：R473.73[医药卫生—护理学]