路径式综合护理干预对乳腺癌放疗患者放射损伤及生活质量的影响  

Effects of path-based comprehensive nursing intervention on radiation injury and quality of life of breast cancer patients undergoing radiotherapy

作　　者：王丽[1] 朱竹华[1] Wang Li;Zhu Zhuhua(Department of Radiotherapy, Jiangyin People's Hospital, Jiangyin Jiangsu,214400,China)

机构地区：[1]江苏省江阴市人民医院放疗科,江苏江阴214400

出　　处：《中外女性健康研究》2021年第12期12-14,44,共4页Women＇s Health Research

摘　　要：目的探讨路径式综合护理干预对乳腺癌术后三维适形调强放疗患者关节功能、皮肤损伤及生活质量的影响。方法选取本院2019年1月至2020年4月80例接受三维适形调强放射治疗的女性乳腺癌术后患者,随机均分为观察组和对照组各40例。对照组接受放疗常规护理,观察组实施路径式综合护理干预,包括皮肤防护、饮食营养指导、生活指导、心理指导和关节功能锻炼等措施。放疗结束后随访2个月,对比两组放疗前后的肩、肘关节功能及生活质量各维度(躯体、心理、社会功能和物质生活)评分和放射性皮肤损伤(按照RTOG急性放射损伤分级标准)发生情况及程度评定。结果放疗前,两组肩、肘关节功能及生活质量核心量表各维度评分无明显差异(P>0.05);放疗后,两组肩、肘关节功能及生活质量各维度评分均明显高于本组放疗前,而观察组肩、肘关节功能及生活质量各维度评分又明显高于对照组(P<0.05)。放疗期间,观察组皮肤反应发生率为75.0%,对照组皮肤反应发生率为95.0%,组间差异显著(P<0.05)。结论对接受三维适形调强放疗的乳腺癌术后患者实施路径式综合护理干预,可明显减轻患者肩、肘关节功能受限及放射性皮肤反应,患者生活质量明显提高。Objective:To explore the effect of path-based comprehensive nursing intervention on joint function,skin damage and quality of life in patients undergoing intensity-modulated radiotherapy after breast cancer surgery.Methods:Eighty female postoperative breast cancer patients undergoing three-dimensional conformal intensity-modulated radiation therapy from January 2019 to April 2020 in our hospital were randomly divided into observation group and control group,40 cases each.The control group received routine radiotherapy care,and the observation group implemented path-based comprehensive nursing interventions,including skin protection,diet nutrition guidance,life guidance,psychological guidance,and joint function exercises.Followed up for 2 months after the completion of radiotherapy,comparing the two groups of shoulder and elbow function and quality of life before and after radiotherapy(somatic,psychological,social function and material life)score and radiation skin injury(according to RTOG acute radiation injury classification standard)situation and degree assessment.Results:Before radiotherapy,there were no significant differences in the scores of the shoulder and elbow joint function and quality of life core scales(P>0.05);after radiotherapy,the scores of the shoulder and elbow joint functions and quality of life were significantly higher than that of this group Before radiotherapy,the observation group's shoulder and elbow joint function and quality of life scores were significantly higher than the control group(P<0.05).During radiotherapy,the incidence of skin reactions in the observation group was 75.0%,and the incidence of skin reactions in the control group was 95.0%.The difference between the groups was significant(P<0.05).Conclusion:The implementation of path-based comprehensive nursing intervention for breast cancer patients undergoing intensity-modulated radiotherapy can significantly reduce the patient's shoulder and elbow joint function limitation and radiation skin reaction,and the patient's quality

关 键 词：乳腺癌 路径式综合护理 三维适形调强放射治疗 关节功能 皮肤反应 生活质量 

分 类 号：R473.71[医药卫生—护理学]