护理干预对鼻咽癌调强适形放疗中口腔黏膜反应的预防作用分析

Analysis of nursing intervention on the prevention of oral mucositis in the intensity modulated conformal radiotherapy

目的观察护理干预措施对鼻咽癌调强适形放疗中患者口腔黏膜反应的预防作用，探讨其临床适用性。方法选择2010年3月。2013年3月第三军医大学附属新桥医院住院治疗的鼻咽癌患者62例，所有患者均采用调强适形放疗进行治疗,将患者分为实验组32例和对照组30例。其中，对照组仅给予放疗后常规护理措施，实验组在此基础上实施护理干预措施。观察两组患者护理有效性及生活质量改善情况，并观察患者合并症情况及对护理的满意情况。结果所有患者调强适形放疗后症状均有所缓解，其中实验组患者的护理治疗有效率达78．13％，明显高于对照组的43133％，差异有统计学意义（χ2=7．90，P〈0．05）。两组患者生理功能、情感职能、社会功能等生活质量评分均有所改善，但实验组患者生活质量评分情况明显优于对照组，差异有统计学意义（P〈0．05）。实验组患者经过护理后，（10＋15）d恢复率达96．88％，明显高于对照组的70．00％，差异有统计学意义（χ2=8．27，P〈0．05）。实验组患者的护理满意度为90．63％，显著高于对照组的70．00％，差异有统计学意义（χ2=4．22，P〈0．05）。结论有效护理干预措施可以改善鼻咽癌调强适形放疗中口腔黏膜反应，适合临床长期推广应用。

Objective To analyze the value of nursing intervention in the intensity modulated conformal radiotherapy. Methods 62 patients with nasopharyngeal carcinoma were treated with intensity modulated conformal radiotherapy in Xinqiao Hospital Affiliated to the Third Military Medical University from March 2010 to March 2013, then they were divided into experiment group with 32 cases and control group with 30 cases, and the control group was treated with routine care measures, while the experiment group was treated with care interventions on this basis. Care effectiveness and improved quality of life and satis- faction were observed between the two groups. Results Symptoms after intensity modulated eonformal radiation therapy in all the patients were eased; care therapeutically effective rate in experimental group was 78.13%, it was higher than that in con- trol group （43.33%）, the differences were statistically significant （X2=7.90,P 〈 0.05）. The quality life score of physiological function, emotional function, social function in the two groups were improved, life quality score of experiment group were better than those of control group, the differences were statistically significant （P 〈 0.05）. Recovery rate within 15 days of experiment group （96.88%） were higher than that of control group （70.00%）, the difference was statistically significant （χ2= 8.27, P 〈 0.05）. Nursing satisfaction of experimental group （90.63%） were higher than that of control group （70.00%）, the difference was statistically significant （χ2=4.22 ,P 〈 0.05）. Conclusion Effective nursing interventions can improve nasopharyngeal carcinoma intensity-modulated radiotherapy in oral mucositis.