针对性护理对甲氨蝶呤治疗原发性中枢神经系统淋巴瘤不良反应的改善效果

Side effect improvement of targeted care for methotrexate treatment of primary central nervous system lymphoma

目的探讨针对性护理对甲氨蝶呤治疗原发性中枢神经系统淋巴瘤不良反应的改善效果,以及对患者生活和护理质量的影响。方法选取2011年1月至2014年8月间收治的原发性中枢神经系统淋巴瘤患者66例,根据就诊顺序编号,按照单双数分为干预组和对照组,每组33例,干预组患者在常规护理基础上应用针对性护理,对照组患者应用常规护理,观察两组患者不良反应,评估患者生活质量、满意度和依从度,应用焦虑自评量表(SAS)和抑郁自评量表(SDS)评估患者治疗后的心理状况。结果干预组患者不良反应发生率为84.8%(28/33),低于对照组的51.5%(17/33),差异有统计学意义(P<0.05)。干预组患者生活质量评分为(68.31±3.10)分,高于对照组的(62.07±2.96)分,差异有统计学意义(P<0.05)。干预组患者SAS和SDS评分分别为(54.22±1.30)分和(12.28±1.26)分,均低于对照组的(59.58±1.27)分和(14.91±1.33)分,差异均有统计学意义(P<0.05)。干预组患者满意度和依从度评分分别为(91.37±4.06)分和(96.08±3.96)分,高于对照组的(83.51±3.22)分和(85.11±4.14)分,差异均有统计学意义(P<0.05)。结论针对性护理可显著降低甲氨蝶呤治疗原发性中枢神经系统淋巴瘤的不良反应,改善患者生活质量和心理状态,提高患者满意度和依从度。

Objective To explore the side effect improvement of the targeted care for methotrexate treatment of primary central nervous system lymphoma and to observe the influence of patients＇ life and nursing quality. Methods From January 2011 to August 2014,66 patients with primary central nervous system lymphoma were enrolled in the study and divided into the intervention group and the control group by single and double according to the visiting sequence number,33 cases in each group. The intervention group accepted with conventional nursing and targeted nursing and the control group accepted conventional nursing.The side effects of two groups was observed,and the life quality,satisfaction and the compliance degree were assessed. Self-rating anxiety scale（ SAS） and self-rating depression scale（ SDS） were used to evaluate psychological conditions after treatment. Results The total adverse reaction of the intervention group was 84. 8%（ 28 /33）,lower than the control group 51. 5%（ 17 /33）,with significant difference（ P〈0. 05）. The life quality of the intervention group was（ 68. 31 ± 3. 10）,higher than the control group（ 62. 07 ± 2. 96）,with significant difference（ P〈0. 05）. SAS and SDS of the intervention group were（ 54. 22 ± 1. 30） and（ 54. 22 ± 1. 26）,lower than the control group [（ 59. 58 ± 1. 27）,（ 14. 91 ± 1. 33） ],with significant differences（ P〈0. 05）. The satisfaction and compliance degree of the intervention group adherence were（ 91. 37 ± 4. 06） and（ 91. 37 ± 3. 96）,higher than the control group [（ 83. 51 ± 3. 22）,（ 85. 11 ± 4. 14） ],with significant differences（ P〈0. 05）. Conclusions Targeted nursing can significantly reduce the side effects of methotrexate therapy of primary central nervous system lymphoma,improve patient life quality and psychological conditions and raise the patients＇ satisfaction and compliance degree.