延续性护理对广泛期小细胞肺癌患者化学治疗依从性及生存状况的影响

Effects of continuous nursing on the chemotherapy compliance and survival status of patients with extensive-stage small cell lung cancer

目的探讨延续性护理对广泛期小细胞肺癌(SCLC)患者化学治疗依从性、生存质量及生存时间的影响。方法选择2013年3月至2015年3月郑州大学附属肿瘤医院收治的广泛期SCLC患者80例,根据护理措施分为观察组和对照组,每组40例。2组患者均给予常规出院指导,观察组患者在常规出院指导的基础上给予出院后延续性护理干预2 a,对2组患者化学治疗依从性、不良反应、心理状态、生活质量及总生存期进行比较。结果观察组和对照组患者完成化学治疗周期数分别为5.30±0.14、4.85±0.18,观察组患者化学治疗周期数多于对照组(t=0.043,P<0.05)。观察组患者完成6个化学治疗周期者24例(60.0%),对照组患者完成6个化学治疗周期者15例(37.5%),观察组患者6个化学治疗周期完成率高于对照组(χ~2=4.051,P<0.05)。观察组和对照组患者化学治疗前心理状态评分分别为35.30±4.12、36.29±2.21,化学治疗结束后4周心理状态评分分别为19.17±3.18、25.00±2.78,化学治疗前2组患者心理状态评分比较差异无统计学意义(t=0.245,P>0.05),2组患者化学治疗结束后4周心理状态评分显著低于化学治疗前(t=10.105、13.297,P<0.05),化学治疗结束后4周观察组患者心理状态评分显著低于对照组(t=12.614,P<0.05)。化学治疗后4周,观察组患者生理状况、社会/家庭状况、情感状况及功能状况显著优于对照组(P<0.05)。观察组和对照组患者中位生存时间分别为13.25、12.50个月,2组患者中位生存时间比较差异无统计学意义(P>0.05,RR=1.108,95%可信区间为0.687~1.788)。结论延续性护理可以提高广泛期SCLC患者的化学治疗依从性,减轻不良反应,改善患者心理状态和生存质量。

Objective To investigate the effect of continuous nursing on the chemotherapy compliance,quality of life and survival time of the patients with extensive-stage small cell lung cancer（ SCLC）. Methods A total of 80 patients with extensive-stage SCLC were selected from March 2013 to March 2015 in the Affiliated Tumor Hospital of Zhengzhou University.The patients were divided into the observation group and the control group according to the nursing measures,with 40 cases in each group. The patients in the two groups were given routine discharging guidance,and the patients in the observation group were given continuous nursing intervention on the basis of routine discharging guidance. The chemotherapy compliance,adverse reaction,mental state,quality of life and total survival time were compared between the two groups. Results The number of completing chemotherapeutic cycle of patients in the observation group and the control group was 5. 30 ± 0. 14 and 4. 85 ± 0. 18 respectively,the number of completing chemotherapeutic cycle in the observation group was significantly more than that in the control group（ t = 0. 043,P 〈 0. 05）. A total of 24（ 60. 0% ） patients had completed 6 chemotherapy cycles in the observation group,and 15（ 37. 5% ） patients had completed 6 chemotherapy cycles in the control group; the completion rate of 6 chemotherapy cycles in the observation group was significantly higher than that in the control group（ χ~2= 4. 051,P 〈 0. 05）. The mental state scores of the patients in the observation group and the control group were 35. 30 ± 4. 12 and 36. 29 ± 2. 21 before chemotherapy respectively,and they were 19. 17 ± 3. 18 and 25. 00 ± 2. 78 at four weeks after chemotherapy. There was no significant difference in mental state score between the two groups before chemotherapy（ t = 0. 245,P 〉 0. 05）,the mental state score at four weeks after chemotherapy was significantly lower than that before chemotherapy in the two groups（ t = 10. 105,13. 297,P 〈 0. 05）,the mental state score in the observation group was significantly lower than that in the control group at four weeks after chemotherapy（ t = 12. 614,P 〈 0. 05）. The physiological status,society and family status,emotional status and functional status of the patients in the observation group were significantly better than those in the control group at four weeks after chemotherapy（ P 〈 0. 05）. The median survival time of the patients in the observation group and the control group was13. 25 and 12. 50 months respectively,there was no significant difference in the median survival time between the two groups（ P 〉 0. 05,RR = 1. 108,95% CI： 0. 687-1. 788）. Conclusion Continuous nursing can improve the chemotherapy compliance,reduce the adverse reaction and improve the mental state and quality of life of the patients with extensive-stage SCLC.