全方位护理对鼻咽癌患者放疗致口腔黏膜反应的效果观察

Effect of comprehensive nursing on radiation-induced oral mucosal reactions in patients with nasopharyngeal carcinoma

目的 探讨拟行放射治疗的鼻咽癌患者采用全方位护理干预对口腔黏膜反应的影响,评估患者的营养状态及生活质量。方法 选取2018年3月至2021年3月间青岛市中心医院收治的112例鼻咽癌患者,采用随机数表法分为对照组和观察组,每组56例。对照组给予传统常规护理,观察组在此基础上采用全方位护理模式。比较两组患者口腔疼痛情况、口腔黏膜炎发生情况、营养状态及生活质量。结果 干预前,两组患者视觉模拟评分(VAS)、血红蛋白、血清总蛋白和白蛋白水平比较,差异无统计学意义(P>0.05)。干预后,两组患者VAS评分均升高,但观察组患者VAS评分低于对照组,且观察组患者血红蛋白、血清总蛋白和白蛋白等营养状态指标均优于对照组,差异均有统计学意义(均P<0.05)。对照组未出现和Ⅰ级口腔黏膜炎患者少于观察组,差异均有统计学意义(均P<0.05);对照组Ⅱ级、Ⅲ级、Ⅳ级口腔黏膜炎发生比例均高于观察组,差异均有统计学意义(均P<0.05)。观察组患者生活质量量表各项评分均高于对照组,差异均有统计学意义(均P<0.05)。结论 拟行放射治疗的鼻咽癌患者采用全方位护理干预,可有效降低患者放射性口腔黏膜反应的发生情况,减轻痛苦,改善营养状态,提高生活质量。

Objective To investigate the effect of comprehensive nursing on radiation-induced oral mucosal reactions in patients with nasopharyngeal carcinoma, and evaluate the nutritional status and quality of life. Methods A total of 112 patients with nasopharyngeal carcinoma treated at Qingdao Central Hospital were selected from March 2018 to March 2021. They were randomly divided into an observation group and a control group with 56 patients in each group. The observation group adopted comprehensive nursing besides conventional nursing and the control group was given traditional routine nursing. The oral pain, incidence of oral mucositis, nutritional status and quality of life were compared between the two groups. Results Before intervention, there was no significant difference in visual analogue scale(VAS) score, hemoglobin, serum total protein and overall protein between the two groups(P>0.05). After the intervention, VAS score increased in the two groups, and it was significantly lower in the observation group than in the control group, and the nutritional status indexes such as hemoglobin, serum total protein and total protein were better in the observation group than in the control group(all P<0.05). The number of patients without oral mucositis and patients with grade I oral mucositis was higher in the observation group than in the control group that(P<0.05). However, the incidence of grade II, III and IV oral mucositis was lower in the observation group than in the control group(P<0.05). Quality of life scores were significantly higher in the observation group than in the control group(all P<0.05). Conclusion Comprehensive nursing intervention can effectively reduce the occurrence of radiation-induced oral mucosal reaction, reduce pain, effectively improve nutritional status and improve quality of life in nasopharyngeal carcinoma patients undergoing radiotherapy.