中药复方抗癌汤联合集束化护理对口腔癌术后患者谵妄及血清CEA、NSE、CA19-9水平的影响

Effect of Compound Anticancer Decoction combined with cluster nursing on delirium and levels of serum CEA,NSE and CA19-9 in postoperative patients with oral cancer

目的探究中药复方抗癌汤联合集束化护理对口腔癌术后患者谵妄及血清CEA、NSE、CA19-9水平的影响。方法2017年9月-2019年9月哈尔滨医科大学附属第一医院口腔颌面外科收治的72例口腔癌患者,以随机数字表法分为常规组和中药联合组,各36例。2组入院后均行集束化护理及全身麻醉下口腔癌根治性切除加淋巴结清扫术治疗,术后接受常规化疗,中药联合组加服中药复方抗癌汤,治疗8周。比较2组的疗效、术后谵妄发生率、谵妄持续时间、血清肿瘤标志物水平、VAS、QoR40评分。结果中药联合组总有效率高于常规组(P<0.05);中药联合组术后谵妄发生率低于常规组(P<0.05);中药联合组谵妄持续时间短于常规组(P<0.05);治疗后,2组血清肿瘤标志物水平水平较治疗前降低,且中药联合组低于常规组(P<0.05);2组术后1 d、2 d、3 d,VAS评分均逐渐降低,QoR4评分均逐渐升高(P<0.05);中药联合组QoR4评分均高于常规组(P<0.05);中药联合组不良反应发生率低于常规组(P<0.05)。结论中药复方抗癌汤联合集束化护理可降低口腔癌术后患者谵妄发生率及血清CEA、NSE、CA19-9水平,缩短谵妄持续时间,减轻癌性疼痛,促进术后恢复,疗效显著,安全性高。

Objective To explore the effect of traditional Chinese medicine Compound Anticancer Decoction combined with cluster nursing on delirium and serum CEA,NSE,CA19-9 levels in patients with oral cancer after operation.Methods 72 patients with oral cancer,treated in the Department of Oral and Maxillofacial Surgery of our hospital from September 2017 to September 2019,were randomly divided into conventional group and traditional Chinese medicine combined group,36 cases in each group.After admission,the two groups were treated with cluster nursing and radical resection of oral cancer and lymph node dissection under general anesthesia.After operation,they both received conventional chemotherapy for 8 weeks,while the combined group was simultaneously treated with Compound Anticancer Decoction.The curative effect,incidence of postoperative delirium,duration of delirium,serum tumor markers level,VAS and QoR40 scores were compared between the two groups.Results The total effective rate in the combined group was significantly higher than that in the conventional group(P<0.05).The incidence of postoperative delirium in the combined group was significantly lower(P<0.05).The duration of delirium in the combined group was significantly shorter(P<0.05).After treatment,the levels of serum tumor markers in the two groups were significantly lower than those before treatment,and the level in the combined group was significantly lower than that in the conventional group(P<0.05).On the 1st d,2nd d,3rd d after operation,the two groups’VAS scores were gradually decreased,and QoR4 scores were gradually increased(P<0.05).QoR4 scores in the combined group were significantly higher than those in the conventional group(P<0.05).The incidence of adverse reactions in the combined group was significantly lower(P<0.05).Conclusion The traditional Chinese medicine Compound Anticancer Decoction combined with bundle nursing can reduce the incidence of postoperative delirium and serum levels of CEA,NSE and CA19-9,shorten the duration of delirium,reduce cancer pain,and promote postoperative recovery,achieving a more significant curative effect and higher safety.