早期系统化护理对食管癌放疗患者的影响研究

Effects of early systematic care on patients with esophageal cancer undergoing radiotherapy

目的探讨早期系统化护理对食管癌放疗患者的影响。方法 2018年1月开始入组合肥市第一人民医院滨湖医院肿瘤科食管癌放疗患者,按随机数字表法随机分为对照组和观察组,截至2020年4月共入组46例,每组各23例。对照组、观察组患者分别接受常规护理和早期系统化护理。比较放疗期间的营养指标、生活质量、放射性食管炎(RE)/肺炎(RP)发生率以及血清炎症因子在2组间的差异。结果 2组患者基线数据比较差异无统计学意义(均P>0.05)。观察组RE发生率为8.70%,明显低于对照组(39.13%,P<0.05);且观察组RP发生率(4.35%)较对照组(17.39%)低,但差异无统计学意义(P>0.05)。观察组患者外周炎症因子IL-6、转化生长因子-β(TGF-β)、S100钙结合蛋白A8(S100A8)重组蛋白(S100A8)、IL-10水平较对照组低(均P<0.05)。观察组患者健康调查简易量表(SF-36)生活质量总评分[(598.30±143.20)分]较对照组[(417.00±200.58)分]显著升高,观察组患者主要营养指标BMI、Hb、ALB、淋巴细胞计数(Lym)均明显高于对照组患者(均P<0.05)。结论早期系统化护理能够改善食管癌放疗患者营养状态,抑制炎症因子释放,降低放射性食管炎发生率,提升生活质量。

Objective To investigate the effects of early systematic nursing care on patients suffering from esophageal carcinoma and receiving radiotherapy.Methods From January 2018 to April 2020,we enrolled 46 patients with esophageal carcinoma and divided into two groups of 23 individuals at random.Usual care or early systematic nursing care was adopted for the control or study group.The nutrition index,quality of life,serum inflammatory factors,occurrence of radiation esophagitis(RE)and pneumonia(RP)were the indicators we used for comparison.Results All pieces of baseline information showed no obvious distinction between the two groups(all P>0.05).The incidence of RE was 8.70%and dramatically attenuated in patients who received early systematic nursing,as compared with that in the control group(39.13%,P<0.05).As for RP,the incident rate was 4.35%in the study group and lower than that in the control(17.39%),but no distinct difference was observed(P>0.05).Patients who received early systematic nursing had remarkably lower serum IL-6,TGF-β,S100 A8 and IL-10 levels than patients who received usual nursing(all P<0.05).Quality of life with SF-36 showed that the total score of the study group[(598.30±143.20)points]was considerably improved when compared with that of the control group[(417.00±200.58)points].Meanwhile,BMI,Hb,ALB and Lym in patients who received early systematic nursing were higher than those in the control group(all P<0.05).Conclusion During radio therapy of patients with esophageal cancer,the early systematic nursing can improve nutritional status and inhibit the release of inflammatory cytokines and may thus be paramount in the suppression of radiation-induced esophagitis and improvement of patients’quality of life.