基于UpToDate预警模式对乳腺癌术后化疗患者不良反应和疾病不确定感的影响  

Effects of UpToDate-based early-warning model on toxic side effects and disease uncertainty in patients receiving postoperative chemotherapy for breast cancer

作　　者：祁海燕[1] 李艳红 田燕妮 董慧敏 张蕾[1] 张学良[2] 安跟会[3] QI Haiyan;LI Yanhong;TIAN Yanni;DONG Huimin;ZHANG Lei;ZHANG Xueliang;AN Genhui(Department of Radiotherapy,Gansu Cancer Hospital,Lanzhou 730050,Gansu Province,China;Department of Gastrointestinal Oncology,Gansu Cancer Hospital,Lanzhou 730050,Gansu Province,China;Department of Nutrition,Gansu Cancer Hospital,Lanzhou 730050,Gansu Province,China)

机构地区：[1]甘肃省肿瘤医院放疗科,甘肃兰州730050 [2]甘肃省肿瘤医院消化肿瘤科,甘肃兰州730050 [3]甘肃省肿瘤医院营养科,甘肃兰州730050

出　　处：《肿瘤》2024年第8期861-867,共7页Tumor

基　　金：甘肃省卫生行业科研计划项目(GSWSKY2018-75);兰州市科技发展指导性计划项目(2022-5-98);甘肃省卫生行业科研计划项目(GSWSKY2020-04)

摘　　要：目的:探讨基于UpToDate的预警模式对乳腺癌术后接受AC-T方案化疗的患者的不良反应和疾病不确定感的影响。方法:纳入2020年10月—2022年10月甘肃省肿瘤医院收治的200例乳腺癌术后接受AC-T方案化疗的患者,随机分为对照组和观察组(各100例)。2组患者均接受手术治疗,术后接受AC-T方案化疗。治疗期间,对照组接受常规专科护理模式,观察组接受基于UpToDate的预警模式,持续干预3个月。比较2组患者的汉密顿尔焦虑量表(Hamilton anxiety scale,HAMA)、汉密顿尔抑郁量表(Hamilton depression rating scale,HAMD)、疾病不确定感量表(medical uncertainty inventory scale,MUIS)和欧洲癌症研究与治疗组织(European Organization for Research and Treatment of Cancer,EORTC)患者生活质量核心量表(EORTC quality of life questionnaire-core 30,EORTC-QLQ-C30)评分以及不良反应。结果:干预3个月后,观察组的HAMA、HAMD和MUIS评分分别为14.39±2.70、10.91±2.22和66.36±7.55分,均显著低于对照组(分别为17.76±4.15、15.62±3.34和76.23±10.31分),差异有统计学意义(P<0.05)。观察组的EORTC-QLQ-C30总生活质量评分为81.23±13.26分,高于对照组的73.69±8.45分(P<0.05);症状量表中,观察组的疲倦、恶性和呕吐以及疼痛评分分别为18.75±3.34、24.72±5.18和22.26±3.04分,均低于对照组(分别为29.03±6.07、35.07±8.15和28.31±5.16分)(P<0.05);单项测试中,观察组的失眠评分为18.65±3.37分,低于对照组的22.60±5.24分(P<0.05)。观察组的恶心和呕吐、食欲减退、腹痛腹泻以及血细胞减少发生率均低于对照组(P<0.05)。结论:基于UpToDate的预警模式可以改善乳腺癌术后化疗患者的心理状态,减少不良反应,降低疾病不确定感,提高生活质量。Objective:To explore the impact of the early warning model based on UpToDate on the adverse reactions and disease uncertainty of patients receiving AC-T chemotherapy after breast cancer surgery.Methods:Two hundred patients with breast cancer who received AC-T chemotherapy after surgery in Gansu Cancer Hospital from October 2020 to October 2022 were included and randomly divided into control group and observation group(100 cases each).Both groups of patients underwent surgical treatment and received AC-T chemotherapy after surgery.During the treatment period,the control group received routine specialized nursing care,while the observation group received a warning mode based on UpToDate,with continuous intervention for 3 months.The psychological status,Hamilton anxiety scale(HAMA),Hamilton depression rating scale(HAMD),medical uncertainty inventory scale(MUIS),and European Organization for Research and Treatment of Cancer quality of life questionnaire core-30(EORTC-QLQ-C30)scores and adverse reactions between two groups were compared.Results:After 3 months of intervention,the HAMA,HAMD and MUIS scores of the observation group were 14.39±2.70,10.91±2.22 and 66.36±7.55,respectively,which were significantly lower than those of the control group(17.76±4.15,15.62±3.34 and 76.23±10.31,respectively),and the differences were statistically significant(all P<0.05).The total quality of life score of the observation group was 81.23±13.26,which was higher than that of the control group(73.69±8.45)(P<0.05).In the symptom scale,the fatigue,malignancy,vomiting,and pain scores of the observation group were 18.75±3.34,24.72±5.18 and 22.26±3.04,respectively,which were lower than those of the control group(29.03±6.07,35.07±8.15 and 28.31±5.16,respectively)(all P<0.05).In the individual test,the insomnia score of the observation group was 18.65±3.37,which was lower than that of the control group(22.60±5.24)(P<0.05).The incidence rates of nausea and vomiting,decreased appetite,abdominal pain and diarrhea,and decreased bl

关 键 词：乳腺癌 化疗 UpToDate预警模式 不良反应 疾病不确定感 

分 类 号：R737.9[医药卫生—肿瘤]