立体定向放射外科治疗乳腺癌脑转移瘤患者的护理体会

Nursing Experience of Stereotactic Radiosurgery for Breast Cancer Patients with Brain Metastases

目的:观察乳腺癌脑转移瘤患者立体定向放射外科(SRS)治疗后的护理方法及应用效果。方法:回顾性分析我科2016年1月至2019年1月期间临床确诊的120例乳腺癌脑转移瘤患者给予立体定向放射外科(SRS)治疗,其中接受常规护理56例(对照组),接受护理干预64例(观察组)。对照组仅按照医嘱放疗后给予脱水、监测生命体征常规护理;观察组除对照组常规护理外,给予心理护理、放疗区皮肤护理、颅内压观察及护理、癫痫防治护理、深静脉置管护理、口腔护理等护理措施。评价两组患者治疗期间毒副反应及放疗前后生活质量评分(QOL)、卡氏评分(KPS)变化。结果:所有患者均完成放疗,观察组较对照组放疗毒副反应发生率明显降低,P﹤0.05,有统计学意义。放疗前对照组QOL评分、KPS评分与观察组相比较,P﹥0.05,无统计学意义;放疗后对照组QOL评分、KPS评分低于观察组,P﹤0.05,有统计学意义。结论:乳腺癌脑转移瘤患者接受放疗期间,配合积极有效的护理,可降低毒副反应发生率,提高患者生活质量,值得临床护理推荐。

Objective:To observe the nursing methods and effect of stereotactic radiosurgery(SRS)for breast cancer patients with brain metastases.Methods:A retrospective analysis of 120 cases of breast cancer brain metastases diagnosed in our department from January 2016 to January 2019 was carried out by stereotactic radiosurgery(SRS).Among them,56 cases received routine nursing(control group),and 64 cases received nursing intervention(observation group).the control group was given routine dehydration,monitoring of vital signs and nursing according to the doctor’s advice after radiotherapy.In addition to the routine nursing care in the control group,the observation group was given psychological nursing,skin care in the radiotherapy area,the observation and nursing of intracranial pressure,the prevention and treatment of epilepsy,the nursing of deep vein catheterization,and the oral nursing.The toxic and side effects of two groups were evaluated,and the quality of life score(QOL)and KPS score before and after radiotherapy were evaluated.Results:All patients completed radiotherapy.The observation group had a significantly lower incidence of toxic side effects than the control group,P﹤0.05,which was statistically significant.The QOL score and KPS score of the control group before radiotherapy were compared with the observation group,P﹥0.05,which was not statistically significant;the QOL score and KPS score of the control group after radiotherapy were lower than the observation group,P﹤0.05,which had statistical significance.Conclusion:During the course of radiotherapy for the patients with brain metastases of breast cancer,combined with active and effective nursing,the incidence of side effects can be reduced and the quality of life of the patients can be improved.It is worthy of clinical nursing recommendation.