局部晚期宫颈癌精确放疗后阴道冲洗护理的效果研究

Effect of Vaginal Irrigation on Patients with Locally Advanced Cervical Cancer After Precise Radiotherapy

目的观察接受精确放疗的局部晚期宫颈癌患者中,两种不同阴道冲洗护理方法的效果.方法2012年4月—2015年5月就治的初治宫颈癌患者47例,均行3DCRT或IMRT及相同剂量放疗.在放疗中均采用0.2%碘伏溶液作为冲洗液进行阴道冲洗,根据冲洗方法不同,将患者分为:实验组24例,采用60 mL注射器连接一次性导尿管为阴道冲洗工具;对照组23例,使用传统"肠道"冲洗器冲洗阴道.观察两组急性放射性阴道炎、阴道黏连及宫腔积液积脓的发生率.结果两组患者在放射性阴道炎、阴道黏连及宫腔积脓积液发生率上差异无统计学意义(P>0.05).实验组发生Ⅱ级放射性阴道炎的比例明显低于对照组(χ^2=0.048,P<0.05).结论阴道冲洗护理在宫颈癌放疗后减轻阴道反应有很好的效果,其中采用60 mL注射器连接一次性导尿管为阴道冲洗工具的方法更具临床优势,值得推广应用.

Objective To observe the effect of two different methods of vaginal irrigation nursing in patients with locally advanced cervical cancer(LACC)receiving precise radiotherapy.Methods From April 2012 to May 2015,47 patients with LACC were treated by 3DCRT or IMRT and the same dose of radiotherapy.During radiotherapy,0.2%iodophor solution was used for vaginal flushing.According to different flushing methods,the patients were divided into experimental group(n=24)and control group(n=23).The incidence of acute radiation vaginitis,vaginal adhesions and empyema of uterine cavity effusion were observed.Results There was no significant difference between the two groups in the incidence of radiation vaginitis,vaginal adhesions and pyometra(P>0.05).The proportion of grade D radiation vaginitis in the experimental group was significantly lower than that in the control group(χ^2=0.048,P<0.05).Conclusion Vaginal irrigation nursing has a good effect on reducing vaginal reaction after radiotherapy for cervical cancer.The method of 60 mL syringe connecting with disposable catheter as vaginal irrigation tool has more clinical advantages and is worth popularizing.