护理干预减少晚期癌痛患者阿片类药物不良反应的效果  

Nursing intervention on reducing adverse reaction of opiates among late-stage cancer

作　　者：袁丽[1] 谭清和[1] 陆勤美[2] 张慎芳[1] 葛晓霞[1] 吉冬丽[1] 

机构地区：[1]江苏省南通市肿瘤医院肿瘤内科,江苏省南通市226361 [2]江苏省南通市肿瘤医院护理部,江苏省南通市226361

出　　处：《中华现代护理杂志》2013年第5期505-508,共4页Chinese Journal of Modern Nursing

基　　金：2011年度南通市科技计划（指导性）项目（S11919）;南通市卫生局2011年重点人才建设项目（W201116）

摘　　要：目的探讨护理干预减少晚期癌痛患者阿片类药物不良反应的效果。方法采用单纯随机抽样法将服用阿片类药物的晚期癌痛患者分为干预组和对照组，对照组给予常规护理，干预组在常规护理基础上给予认知、心理、健康行为、饮食以及用药等干预。结果两组患者恶心呕吐、尿潴留发生率差异有统计学意义（X^2值分别为3．948，4．241；P〈0．05），便秘发生率差异有显著统计学意义（X^2=7．394，P〈0．01），嗜睡、头晕、呼吸抑制发生率差异无统计学意义（P〉0．05）。干预组患者整体生活质量得分高于对照组[（62．01±4．27）比（54．83±5．01）分]，差异有显著统计学意义（t=7．0145，P〈0．01），生存质量各分量表得分两组差异均有统计学意义（P〈0．01）。结论护理干预可有效降低晚期癌痛患者因阿片类药物引起的恶心、呕吐和尿潴留尤其是便秘的发生率，显著提高癌痛患者的生存质量。Objective To explore the ettect ot nursing intervention on reducing adverse reaction ot opiates among late-stage cancer with pain. Methods Late-stage cancer patients were randomly divided into intervention group and control group, and the control group received the routine nursing, while the intervention group received the nursing intervention in the aspects of cognition, psychology, health behavior, diet and drug use on the base of routine nursing. Results After the intervention, significant difference was found in the incidence of nausea and vomit, urinary retention, and constipation between the two groups （ X^2 = 3. 948,4. 241, 7. 394,respectively;P 〈0.05）, while the incidence of sleepiness, dizziness and respiratory depression in the two groups was not significant different （ P 〉 0.05 ）. The global quality of life score of the intervention group was significantly higher than that of the control group E （62. 01 ± 4.27 ） vs （ 54.83 ± 5. Ol ） ; t = 7.014 5, P 〈 0.01] , so as to the dimension scores （P〈0.01）. Conclusions Nursing intervention in late-stage cancer can significantly reduce the incidence of adverse reaction of opiates such as nausea and vomit, urinary retention, and constipation so as to improve their life quality.

关 键 词：镇痛药 阿片类 不良反应 晚期癌痛 护理干预 

分 类 号：R473.73[医药卫生—护理学]