综合干预在肺癌化疗患者症状簇中的效果评价  

Efficacy of comprehensive intervention for symptom clusters in lung cancer patients receiving chemotherapy therapy

作　　者：王艳 何瑞仙[2] 刘妍[3] 苏伟才 黄秀秀 翟敏峰 胡雪楠 张淑香 胡尚英[4] 任建松[5] 刘金英 李宁[7] WANG Yan;HE Rui-xian;LIU Yan;SU Wei-cai;HUANG Xiu-xiu;ZHAI Min-feng;HU xue-nan;ZHANG Shu-xiang;HU Shang-ying;REN Jian-song;LIU Jin-ying;LI Ning(Department of Internal Medicine,National Cancer Center/National Clinical Medicine Research Center for Cancer/Chinese Academy of Medical Sciences and Peking Union Medical College Cancer Hospital,Beijing 100021,China;Department of Nursing,National Cancer Center/National Clinical Medicine Research Center for Cancer/Chinese Academy of Medical Sciences and Peking Union Medical College Cancer Hospital,Beijing 100021,China;Department of Radiotherapy,National Cancer Center/National Clinical Medicine Research Center for Cancer/Chinese Academy of Medical Sciences and Peking Union Medical College Cancer Hospital,Beijing 100021,China;Department of Epidemiological Research Room,National Cancer Center/National Clinical Medicine Research Center for Cancer/Chinese Academy of Medical Sciences and Peking Union Medical College Cancer Hospital,Beijing 100021,China;Office for Early Diagnosis and Treatment of Cancer,National Cancer Center/National Clinical Medicine Research Center for Cancer/Chinese Academy of Medical Sciences and Peking Union Medical College Cancer Hospital,Beijing 100021,China;Nutrition Room,National Cancer Center/National Clinical Medicine Research Center for Cancer/Chinese Academy of Medical Sciences and Peking Union Medical College Cancer Hospital,Beijing 100021,China;General Department,National Cancer Center/National Clinical Medicine Research Center for Cancer/Chinese Academy of Medical Sciences and Peking Union Medical College Cancer Hospital,Beijing 100021,China)

机构地区：[1]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院内科,北京100021 [2]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院护理部,北京100021 [3]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院放疗科,北京100021 [4]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院流行病研究室,北京100021 [5]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院癌症早诊早治办公室,北京100021 [6]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院营养室,北京100021 [7]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院综合科,北京100021

出　　处：《中国肿瘤临床与康复》2020年第10期1214-1219,共6页Chinese Journal of Clinical Oncology and Rehabilitation

基　　金：北京协和医学院协和青年基金项目(2017330025)。

摘　　要：目的探讨综合干预在肺癌化疗患者症状簇中的效果评价。方法选取2017年4月至2017年12月间中国医学科学院肿瘤医院收治的84例肺癌化疗患者,将2017年4月至7月间化疗的43例患者纳入对照组,2017年9月至12月间化疗的41例患者纳入干预组。对照组患者采用常规护理,干预组患者在常规护理基础上采用2个化疗周期的饮食处方指导、音乐放松疗法和医患家庭支持的综合干预,比较两组患者第1、2化疗周期的症状簇,分析综合干预效果。结果两组患者在性别、年龄、婚姻状况、教育程度、个人月收入、吸烟史、化疗方案和疾病分期等方面比较,差异均无统计学意义(P>0.05)。干预组患者有饮酒史者占31.7%,高于对照组的9.3%,差异有统计学意义(P<0.05)。第1化疗周期,两组患者苦恼、胃口差和健忘发生率比较,差异均有统计学意义(均P<0.05)。第2化疗周期,两组患者疲劳、苦恼、口干和麻木感发生率比较,差异均有统计学意义(均P<0.05)。第1、2化疗周期后,两组患者消化道症状簇和病感症状簇比较,差异均有统计学意义(均P<0.05)。两组间心理症状簇比较,差异无统计学意义(P>0.05)。第1化疗周期后,两组患者情绪、走路和生活乐趣发生率比较,差异均有统计学意义(均P<0.05)。第2化疗周期后,两组患者一般活动、工作劳动和生活乐趣发生率比较,差异均有统计学意义(均P<0.05)。结论在常规护理基础上采用综合干预,可缓解肺癌化疗患者的部分症状簇,改善生活质量,值得临床推广应用。Objective To evaluate the efficacy of comprehensive intervention for symptom cluster in lung cancer patients undergoing chemotherapy.Methods From April 2017 to December 2017,84 patients with lung cancer who admitted to Chinese Academy of Medical Sciences and Peking Union Medical College Cancer Hospital were included in an intervention group and 43 patients who received chemotherapy from April 2017 to July 2017 were included in a control group.The intervention group was given comprehensive intervention including guidance to the dietary,music therapy for relaxation and the doctor-patient-family support during the 2 cycles of chemotherapy besides conventional nursing and the control group was only given conventional nursing.Symptom cluster was compared between the two groups during the 1st and 2nd cycle of chemotherapy.The efficacy of intervention was analyzed.Results There was no significant difference in gender,age,marital status,education status,personal monthly income,chemotherapy regimen and disease stage between the two groups(P>0.05).Thirty-one point seven percent patients had the history of smoking,which was higher than 9.3%of the control group(P<0.05).During the 1st cycle of chemotherapy,there were significant differences in the incidence of bother,poor appetite and obliviousness between the two groups(all P<0.05).During the 2nd cycle of chemotherapy,there were significant differences in the incidence of fatigue,bother,dry mouth and numbness between the two groups(all P<0.05).After the 2 cycles of chemotherapy,significant differences were noticed in symptoms clusters consisting of digestive tract symptoms and illness perception between the two groups(all P<0.05).After the 1st cycle of chemotherapy,there were significant differences in feelings,walking and joy of life between the two groups(all P<0.05).After the 2 cycles of chemotherapy,there were significant differences in general activities,working and joy of life between the two groups(all P<0.05).Conclusion On the basis of conventional nursing,comprehens

关 键 词：肺肿瘤 药物疗法 护理干预 症状簇 纵向研究 

分 类 号：R730.5[医药卫生—肿瘤]