护理干预对肺癌呼吸困难患者的影响

Impact of nursing intervention for patients with lung cancer dyspnea

目的探讨护理干预对肺癌呼吸困难患者的影响。方法 2006年7月至2012年7月住院治疗的80例肺癌患者,按照入院顺序分为对照组和观察组。对照组36例患者给予常规的护理,观察组44例患者在常规护理的基础上给予针对性护理干预。对比两组患者的近期疗效、DLL4蛋白和VEGF蛋白阳性表达率、放射治疗体积、5年生存率、心理状况改善情况及视觉模拟量表(VAS)评分。结果 (1)对照组患者的近期总有效率为66.7%,明显低于观察组(84.1%),二者差异有统计学意义(P<0.05)。(2)对照组护理前后DLL4蛋白阳性表达率分别为83.3%和75.0%,VEGF蛋白阳性表达率分别为77.8%和69.4%,治疗前后DLL4蛋白与VEGF蛋白阳性表达率差异均无统计学意义(P>0.05);观察组护理干预前后DLL4蛋白阳性表达率分别为88.6%和18.2%,VEGF蛋白阳性表达率分别为77.3%和11.4%,护理干预前后DLL4蛋白与VEGF蛋白阳性表达率差异均具有统计学意义(P<0.05)。且观察组患者护理后较对照组患者护理后DLL4蛋白与VEGF蛋白差异具有统计学意义(P<0.05)。(3)观察组患者放疗体积明显小于对照组,二者差异具有统计学意义(P<0.05)。(4)两组的5年生存率差异具有显著的统计学意义(P<0.05)。(5)对照组患者护理前后焦虑自评量表(SAS)与抑郁自评量表(SDS)评分差异具有统计学意义(P<0.05);观察组患者护理前后两种评分差异具有统计学意义(P<0.05)。(6)两组患者护理后3周与6周VAS评分差异均有统计学意义(P<0.05)。结论针对性护理干预能够明显提高肺癌患者的近期疗效和5年生存率,且可明显改善患者的心理状况及呼吸状况,可在临床推广应用。

Objective To investigate the impact of nursing interventions on lung cancer patients with dyspnea. Methods 80 cases of patients with clinical diagnosis of lung cancer stayed in our hospital during July 2006 to July 2012 were randomly divided into control group and observation group. The control group （n = 36 ） accepted the conventional care, and the observation group （n =44） were given the targeted nursing intervemion on the basis of conventional care, and the short-term effect, DLIA protein and VEGF protein expression rate, ra- diotherapy volume, 5-year overall survival rate, situation of psychological conditions improvement and the visual analogue scale （VAS） scores were compared between the two groups. Results （1） The total effective rate of the control group in the near future was 66. 7%, which was significantly lower than the observation group （84. 1% ）, and there was a statistical difference （P 〈0. 05）. （2） The positive expression rate of DIJA protein was 83.3%, 75.0% respectively in the control group before and after intervention, and the positive expression of VEGF protein was 77. 8%, 69. 4%, respectively and there was no statistical difference of DLL4 protein and VEGF protein＇s positive expression rate in this group before and after treatment （P 〉 0. 05）. The positive ex- pression of DLL4 protein was 88. 6%, 18. 2% respectively in the observation group before and after intervention, and the positive expression of VEGF protein was 77. 3%, 11.4% respectively, and there was a significantly sta- tistical difference of DLL4 protein and VEGF protein＇s positive expression rate in this group before and after treat-ment （P 〈 0. 01）. And there was a significantly statistical difference of the DLIA and VEGF protein＇ s positive expression rate in the observation group in comparison with the control group after nursing （P 〈 0. 01 ）. （3） The radiotherapy volume in the observation group was significantly smaller than the control group, and there was a statistical difference （P 〈0. 05）. （g） According to the Kaplan-Meir method, 5-year survival rate was calculated, and there was a significantly statistical difference between the two groups （P 〈0. 001）. （5）Based on self-rating scale （SAS） and Self-Rating Depression Scale （SDS）scores before and after care, the control group showed sta- tistically significance （P 〈 0. 05）, as well the observation group （P 〈 0. 01 ）. （6） two groups of patients after three weeks and six weeks of care, VAS score had a significantly difference （P 〈0. 01）. Conclusions Targeted nursing intervention can significantly improve the efficacy and 5-year survival rate of the patients with lung canc- er, and can significantly improve the patient~ mental status and respiratory situation, and it could be promo- ted and applied.