云医院护理管理模式对中晚期HCC患者靶向药物治疗的影响

Effect of Cloud Hospital Nursing Management Model on Targeted Drug Therapy for Patients with Advanced HCC

目的:探讨云医院护理管理模式对肝细胞癌(hepatocellular carcinoma,HCC)患者靶向药物治疗的影响。方法:选取2020年9-12月福建医科大学孟超肝胆医院收治的76例初次接受口服靶向药物治疗的中晚期HCC患者。按1∶1随机将其分为对照组和试验组,每组38例。对照组给予传统家庭管理,试验组给予云医院护理管理模式。比较两组出院后1个月的不良反应发生率,靶向药物剂量调整情况、服药依从性。结果:两组不良反应发生率比较差异无统计学意义(P>0.05),发生率在前5位的不良反应分别为腹泻、纳差、高血压、乏力、手足综合征。两组手足综合征、高血压、体重降低、纳差、恶心、腹泻、脱发、乏力、皮疹、出血、声音嘶哑、黏膜炎、疼痛发生率比较差异均无统计学意义(P>0.05),此外,两组≥3级不良反应发生率比较差异无统计学意义(P>0.05)。试验组停药3例(7.9%),调整剂量5例(13.2%),对照组停药13例(34.2%),调整剂量6例(15.8%),对照组出院后1个月进行剂量调整和/或停药的比率显著高于试验组(P<0.05)。试验组服药依从性显著优于对照组(P<0.05)。结论:云医院护理管理模式有助于医患双向互动,实现对中晚期HCC患者服用靶向药物过程中持续、动态干预,针对患者出现的靶向药物相关不良反应实现早期干预,从而避免不必要的剂量调整及治疗中断,提高患者服药依从性。

Objective:To explore the effect of cloud hospital nursing management model on targeted drug therapy for patients with advanced hepatocellular carcinoma (HCC).Method:A total of 76 patients with advanced HCC who received oral targeted drug therapy for the first time in Mengchao Hepatobiliary Hospital,Fujian Medical University were selected from September to December 2020.They were randomly divided into control group and experimental group according to 1∶1,38 cases in each group.The control group was given traditional family management,and the experimental group was given cloud hospital nursing management model.The incidence of adverse reactions,dose adjustment condition of targeted drugs and medication compliance were compared between the two groups one month after discharge.Result:There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).The top five adverse reactions were diarrhea,poor appetite,hypertension,fatigue and hand foot syndrome.There were no significant differences in the incidence of hand foot syndrome,hypertension,weight loss,poor appetite,nausea,diarrhea,hair loss,fatigue,rash,bleeding,hoarseness,mucositis and pain between the two groups (P>0.05).In addition,there was no significant difference in the incidence of grade ≥3 adverse reactions between the two groups (P>0.05).In the experimental group,3 cases (7.9%) stopped medication,5 cases (13.2%) adjusted dose,and in the control group,13 cases (34.2%) stopped medication,and 6 cases (15.8%) adjusted dose.The rate of dose adjustment and/or stopped medication in the control group one month after discharge was significantly higher than that in the experimental group (P<0.05).The medication compliance of experimental group was significantly better than that of control group (P<0.05).Conclusion:Cloud hospital nursing management model is conducive to doctor-patient two-way interaction,realizing continuous and dynamic intervention in the course of taking targeted drugs for patients with advanced HCC,and realizing early intervention for adverse reactions related to targeted drugs in patients,so as to avoid unnecessary dose adjustment and treatment interruption and improve patients’ medication compliance.