心理护理对中晚期原发性肝癌化疗相关性恶心呕吐的影响  

Effect of psychological nursing on chemotherapy-induced nausea and vomiting in patients with advanced primary liver cancer

作　　者：杨建芬 沈永奇 孔祥应 陈超庭 斯韬[4] 王志祥[5] 谢华东 YANG Jian-fen;SHEN Yong-qi;KONG Xiang-ying;CHEN Chao-ting;SI Tao;WANG Zhi-xiang;XIE Hua-dong(Department of Oncology,Guangxi Medical University Affiliated Liutie Central Hospital,Liuzhou 545007,China;Department of Oncology,Third Affiliated Hospital of Guiyang College of Traditional Chi-nese Medicine,Duyun 55800,China;The Second Department of Chemotherapy,The Second Affiliated Hospital of Guangxi University of Science And Technology,Liuzhou 545006,China;The Second Depart-ment of Oncology,The Third Affiliated Hospital of Guangxi University of Traditional Chinese Medicine,Li-uzhou 545001,China;The First Department of Oncology,The Third Affiliated Hospital of Guangxi Uni-versity Of Traditional Chinese Medicine,Liuzhou 545001,China;Department of Oncology,Liuzhou Rongshui County People＇s Hospital,Liuzhou 545300,China)

机构地区：[1]广西医科大学附属柳铁中心医院肿瘤科,柳州545007 [2]贵阳中医学院第三附属医院肿瘤科,都匀558004 [3]广西科技大学第二附属医院化疗二科,柳州545006 [4]广西中医药大学第三附属医院肿瘤科二科,柳州545001 [5]广西中医药大学第三附属医院肿瘤科一科,柳州545001 [6]广西柳州市融水县人民医院肿瘤科,柳州545300

出　　处：《中国肿瘤临床与康复》2018年第9期1143-1146,共4页Chinese Journal of Clinical Oncology and Rehabilitation

基　　金：广西卫计委科研项目(Z2014408);柳州市科技攻关项目(2014J030424)

摘　　要：目的探讨心理护理对中晚期原发性肝癌(PLC)化疗相关性恶心呕吐(CINV)的影响。方法选取2013年7月至2017年3月间6个肿瘤中心收治的109例中晚期原发性肝癌患者,采用随机数表法分为观察组(57例)和对照组(52例)。两组患者均行化疗治疗、常规对症支持治疗和常规护理,观察组患者同时进行心理护理干预,观察两组患者每疗程化疗发生CINV的比例及强度。结果观察组患者共完成296个化疗周期,对照组患者共完成243个化疗周期。观察组患者化疗相关性恶心和呕吐发生率分别为43.6%和35.5%,对照组分别为53.1%和46.9%,两组比较,差异均有统计学意义(均P<0.05)。两组患者均无Ⅳ~Ⅴ度化疗相关性呕吐发生;两组患者Ⅰ度CINV比较,差异无统计学意义(P>0.05)。观察组患者Ⅱ度、Ⅲ度化疗相关性恶心发生率分别为14.2%和10.1%,对照组患者分别为21.0%和16.9%,两组比较,差异均有统计学意义(均P<0.05);观察组患者Ⅱ度、Ⅲ度化疗相关性呕吐发生率分别为12.5%和9.5%,对照组分别为18.9%和15.2%,两组比较,差异均有统计学意义(均P<0.05)。经积极处理,以上恶心呕吐均可缓解。结论对原发性肝癌患者采用心理护理干预,可减少、减轻化疗相关性恶心呕吐。Objective To evaluate the effect of psychological nursing on chemotherapy-induced nausea and vomiting （CINV） in patients with advanced primary liver cancer （PLC）. Methods One hun-dred and nine patients with advanced PLC admitted to 6 cancer center hospitals from July 2013 to March 2017 were selected and divided into an observation group （57 patients） and a control group （52 patients）. Both groups received chemotherapy and conventional care. Concurrently, the observation group was also giv- en psychological nursing but the control group was not. The incidence and strength of CINV duiring each course were investigated in this study. Results Two hundred and ninety-six chemotherapy cycles were car- ried out in the observation group and 243 chemotherapy cycles were completed in the control group. The inci- dence of chemotherapy-induced nausea and vomiting was 43.6% and 35.5%, respectively in the two groups and 53.1% and 46. 9% , respectively in the control group （ all P 〈0. 05）. No grade IV ~Ⅴ chemotherapy associated vomiting occurred in the two groups and there was no difference in grade I CINV between the two groups （P 〉0. 05）. The incidence of grade Ⅱ and Ⅲ chemotherapy associated nausea was 14. 2% and 10. 1%, respectively for the observation group and 21.0% and 16. 9% , respectively for the control group （all P 〈 0. 05 ）. The incidence of grade Ⅱ and Ⅲ chemotherapy associated vomiting was 12. 5% and 9.5%, respectively for the observation group and 18.9% and 15.2% , respectively for the control group （ all P 〈 0. 05 ）. Conclusion Psychological nursing can reduce the incidence rate and decrease severity degree of CINV in patients with advanced primary liver cancer.

关 键 词：肝肿瘤 恶心 呕吐 心理疗法 

分 类 号：R735.7[医药卫生—肿瘤]