综合优质护理干预在腹腔热灌注化疗治疗结肠癌患者中的应用评价

Evaluation of the application of comprehensive high quality nursing intervention in intraperitoneal hyperthermic perfusion chemotherapy for colon cancer

目的研究结肠癌患者在腹腔热灌注化疗期间接受综合优质护理干预的临床价值。方法前瞻性研究,将2022年8月至2023年7月在广州市第一人民医院接受腹腔热灌注化疗的100例结肠癌患者,按随机数字表方式分成两组,各50例。对照组男性28例,女性22例;年龄42~76(58.36±2.71)岁;采取常规化疗护理。观察组男性29例,女性21例;年龄40~73(58.15±2.58)岁;采取综合优质护理干预。对比两组患者护理前与护理7 d后癌因性疲乏、疼痛程度、睡眠质量、心理状态评分、免疫功能、炎症反应相关指标、不良反应发生率、护理满意度。统计学方法采用t检验、χ^(2)检验。结果护理后,观察组视觉模拟评分法(VAS)、匹兹堡睡眠质量指数(PSQI)、癌因性疲乏评估量表评分均低于对照组[(2.43±0.18)分比(4.16±0.25)分、(2.43±0.18)分比(7.16±1.25)分、(2.42±0.06)分比(5.16±0.17)分],差异均有统计学意义(t=39.71、26.48、107.47,均P<0.05);观察组焦虑自评量表(SAS)、抑郁自评量表(SDS)评分均低于对照组[(17.19±1.08)分比(33.52±1.64)分、(18.43±1.68)分比(32.16±2.05)分],差异均有统计学意义(t=58.80、36.63,均P<0.05)。观察组护理后免疫功能、炎症反应相关指标均优于对照组,差异均有统计学意义(均P<0.05);观察组不良反应发生率(免疫抑制、静脉炎、胃肠道反应)均低于对照组,差异均有统计学意义(χ^(2)=10.19、7.11、13.56,均P<0.05);观察组护理满意度高于对照组[94.00%(47/50)比80.00%(40/50)],差异有统计学意义(χ^(2)=4.33,P<0.05)。结论结肠癌患者在腹腔热灌注化疗期间接受综合优质护理干预,能够帮助改善免疫功能和睡眠质量,控制疼痛、癌因性疲乏、炎症反应,减少不良反应,使患者保持良好心态,提升护理满意度。

Objective To study the clinical value of comprehensive high quality care intervention in colon cancer patients during intraperitoneal hyperthermic perfusion chemotherapy.Methods A prospective study was conducted.A total of 100 colon cancer patients who underwent intraperitoneal hyperthermic perfusion chemotherapy in Guangzhou First People's Hospital from August 2022 to July 2023 were divided into two groups using the random number table method.In the control group,there were 28 males and 22 females,and the age was 42-76(58.36±2.71)years old.In the observation group,there were 29 males and 21 females,and the age was 40-73(58.15±2.58) years old. The control group received routine chemotherapy care, and the observation group received comprehensive high-quality nursing intervention. The cancer-related fatigue, pain degree, sleep qualities, psychological state scores, immune function, inflammatory response related indicators, incidences of adverse reactions, and nursing satisfaction were compared between the two groups before and after 7 days of nursing. Statistical methods used were t test and χ^(2) test. Results After nursing, the scores of Visual Analogue Scale (VAS), Pittsburgh Sleep Quality Index (PSQI), and Cancer-Related Fatigue Assessment Scale of the observation group were lower than those of the control group [(2.43±0.18) points vs. (4.16±0.25) points, (2.43±0.18) points vs. (7.16±1.25) points, (2.42±0.06) points vs. (5.16±0.17) points], with statistically significant differences (t=39.71, 26.48, and 107.47, all P<0.05). After nursing, the scores of Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) in the observation group were lower than those in the control group [(17.19± 1.08) points vs. (33.52±1.64) points, (18.43±1.68) points vs. (32.16±2.05) points], with statistically significant differences (t=58.80 and 36.63, both P<0.05). The related indicators of immune function and inflammatory response in the observation group after nursing were better than those in the control group, with statistically significant differences (all P<0.05). The incidences of adverse reactions (immunosuppression, phlebitis, and gastrointestinal reactions) in the observation group were lower than those in the control group, with statistically significant differences (χ^(2)=10.19, 7.11, and 13.56, all P<0.05). The nursing satisfaction of the observation group was higher than that of the control group [94.00% (47/50) vs. 80.00% (40/50)], with a statistically significant difference (χ^(2)= 4.33, P<0.05). Conclusion Colon cancer patients receive comprehensive high quality nursing intervention during intraperitoneal hyperthermic perfusion chemotherapy, which helps to improve the immune function and sleep quality, control the pain, cancer-related fatigue, and inflammation, reduce the adverse reactions, and keep a good attitude, so as to improve the nursing satisfaction.