食管癌患者放化疗期间实施综合心理护理干预的效果评价

Efficacy of comprehensive mental nursing in patients with esophageal cancer during concurrent chemoradiotherapy

目的:探究食管癌患者在放化疗期间实施综合心理护理干预的临床疗效,为食管癌患者放化疗期间的临床护理提供更为有效的手段和方法.方法:从2011-10/2014-10于江苏省连云港市第二人民医院诊治的接受同步放化疗的食管癌患者中选择120例患者作为研究对象并随机分为2组,即常规护理组和综合护理组,每组患者各60例.2组患者均给予相同的食管癌同步放化疗方法治疗.在放化疗期间综合护理组患者实施综合心理护理干预,而常规护理组仅给予传统常规护理.分别观察2组患者护理干预后生活质量的变化情况及放化疗期间发生的不良反应,并评价2组护理干预的临床疗效.结果:综合护理组患者实施综合心理护理干预后,其Spitzer生活质量指数评分显著高于常规护理组(P<0.001);在放化疗期间,综合护理组患者不良反应(包括消化系反应、肝功能异常、骨髓抑制、肾功能异常以及放射性食管炎)的发生率均显著低于常规护理组(P=0.006、0.013、0.003、0.027、0.010).结论:对接受同步放化疗的食管癌患者实施综合心理护理干预,能预防和显著减少患者放化疗不良反应的发生,并改善和提高患者的生活质量,值得在临床上推广应用.

AIM： To evaluate the clinical efficacy of comprehensive mental nursing in patients with esophageal cancer during concurrent chemo-radiotherapy. METHODS： One hundred and twenty patients with esophageal cancer who underwent concurrent chemo-radiotherapy at the Second People’s Hospital of Lianyungang from October 2011 to October 2014 were randomly divided into a comprehensive nursing group and a routine nursing group, with 60 patients in each group. All patients were given the same chemo-radiotherapy. The patients in the comprehensive nursing group were given comprehensive mental nursing intervention by evaluating their mental status, individual needs and adverse reactions during concurrent chemo-radiotherapy, and the routine nursing group were only given conventional nursing. The quality of life after nursing intervention and the adverse reactions during concurrent chemo-radiotherapy were observed, and the clinical efficacy was evaluated. RESULTS： The Spitzer quality of life index was significantly higher in the comprehensive nursing group than in the routine nursing group after nursing intervention（P 〈 0.001）. The incidence rate of adver sereactions including gastrointestinal reactions, liver dysfunction, bone marrow suppression,renal dysfunction and radiotherapy-induced esophagitis was significantly lower in the comprehensive nursing group than in the routine nursing group（ P = 0.006,0.013,0.003,0.027,0.010）. Ten cases in the routine nursing group discontinued treatment due to serious adverse reactions, but all patients in the comprehensive nursing group completed the concurrent chemo-radiotherapy under supportive and symptomatic treatment.CONCL ION：Giving comprehensive mental nursing intervention to patients with esophageal cancer undergoing concurrent chemo-radiotherapy can significantly reduce and prevent adverse reactions and effectively improve the patients’ quality of life.