集束化护理干预在鼻咽癌患者放射性皮炎防治中的应用

Application of cluster nursing intervention in the prevention and treatment of radioactive dermatitis in patients with nasopharyngeal carcinoma

目的探讨集束化护理干预在鼻咽癌患者放射性皮炎防治中的应用。方法选取2019年1月至2021年2月广西壮族自治区梧州市红十字会医院肿瘤科接受首次根治性放疗的鼻咽癌患者210例为研究对象,采用随机数字表分为观察组和对照组,研究过程中依从性差退出2例、病情变化转科2例,最后纳入206例鼻咽癌患者为研究对象,其中观察组105例,对照组101例。对照组实施常规护理,观察组在对照组的基础上实施基于循证的集束化护理干预。观察评估患者放疗后各级皮炎的发生率和发生时间、皮炎的严重程度、皮肤损伤体征出现的时间。结果两组皮炎发生率比较,差异无统计学意义(P>0.05)。观察组皮肤损伤体征出现的时间长于对照组、皮炎总得分低于对照组(P<0.05)。两组Log-rank检验分析显示观察组无2级皮炎的时间长于对照组(P<0.05)。结论与常规护理比较,集束化护理干预可以延缓放射性皮炎的发生,降低皮炎的严重程度。

Objective To explore the application of cluster nursing intervention in the prevention and treatment of radioactive dermatitis in patients with nasopharyngeal carcinoma.Methods A total of 210 nasopharyngeal carcinoma patients who received the first radical radiotherapy in the Department of Oncology Wuzhou Red Cross Hospital,Guangxi Zhuang Autonomous Region from January 2019 to February 2021 were selected as the study subjects.A random number table was used to divide the patients into observation group and control group.During the study,two patients with poor compliance quit and two patients with disease change were transferred to the department.Finally,206 patients with nasopharyngeal carcinoma were included as the research objects,including 105 cases in observation group and 101 cases in control group.The control group received routine nursing,and the observation group received evidence-based cluster nursing intervention on the basis of the control group.The incidence and time of dermatitis at all levels,the severity of dermatitis and the time of appearance of skin injury signs were observed and evaluated after radiotherapy.Results There was no significant difference in the incidence of dermatitis between the two groups(P>0.05).The time of appearance of skin injury signs in the observation group was longer than that in the control group,and the total dermatitis score was lower than that in the control group(P<0.05).Log-rank test analysis of the two groups showed that the time of grade 2 dermatitis in the observation group was longer than that in the control group(P<0.05).Conclusion Compared with conventional nursing,cluster nursing intervention can delay the occurrence of radiation dermatitis and reduce the severity of dermatitis.