EXCAP锻炼在多发性骨髓瘤化疗所致周围神经病变患者中的应用研究

Research on application of exercise for cancer patients on chemotherapy-induced peripheral neuropathy for patients with multiple myeloma

目的探讨EXCAP锻炼在多发性骨髓瘤化疗所致周围神经病变患者中的应用效果。方法便利选取2021年1月-12月在浙江大学医学院附属第一医院血液科接受药物化疗后出现周围神经病变的多发性骨髓瘤患者为研究对象,按患者收治不同病区分成对照组和试验组,各43例。对照组采用常规护理方案,试验组在常规护理基础上实施EXCAP锻炼。于入组日、干预后6周使用癌症治疗相关神经毒性功能量表、美国国立癌症协会药物毒性评分标准4.0版、疼痛数字评分量表、匹兹堡睡眠质量指数量表比较两组患者周围神经病变症状程度、疼痛、睡眠状况等方面的差异。结果干预6周后,两组周围神经病变程度分级比较(Z=-5.019,P<0.001)、神经疼痛评分比较(t=5.275,P<0.001)、癌症治疗相关神经毒性功能量表总分比较(t=6.979,P<0.001)及睡眠质量指数总分比较(t=7.558,P<0.001)差异有统计学意义。结论EXCAP锻炼能有效降低多发性骨髓瘤化疗所致周围神经病变程度,减轻周围神经病变疼痛水平,改善患者睡眠质量,提高患者生活质量。

Objective To study the application effect of exercise for cancer patients(EXCAP)on chemotherapy-induced peripheral neuropathy(CIPN)for patients with multiple myeloma.Method Choose CIPN patients with multiple myeloma after receiving chemotherapy in department of hematopathy in The First Affiliated Hospital Zhejiang University School of Medicine from January to December 2021 by convenient sampling.Divide patients into observation group(n=43)and control group(n=43)according to different wards.Patients in control group receive routine nursing scheme.Patients in observation group receive EXCAP based on routine nursing care.Compare the peripheral neuropathy degree,pain and sleeping status between two groups by Functional Assessment of Cancer Therapy/Gynaecologic Oncology Group-Neurotoxicity Scale(FACT/GOG-Ntx),National Cancer Institute-Common Toxicity Criteria(NCI-CTC 4.0),Numerical Rating Scale(NRS)and Pittsburgh Sleep Quality Index(PSQI)when forming the groups and six weeks after intervention.Result The difference is significant on comparison of score on peripheral neuropathy grading(Z=-5.019,P<0.001),score on NRS(t=5.275,P<0.001),FACT/GOG-Ntx(t=6.979,P<0.001)and total score on PSQI(t=7.558,P<0.001)between two groups six weeks after intervention.Conclusion EXCAP can reduce CIPN for patients with multiple myeloma effectively,reduce pain level of peripheral neuropathy,improve patients’sleeping quality and their quality of life.