结构化皮肤护理管理在乳腺癌放疗后皮损患者中的应用效果

Application effects of structured skin nursing management in patients with skin lesions after radiotherapy for breast cancer

目的:观察结构化皮肤护理管理在乳腺癌放疗后皮损患者中的应用效果。方法:选取2020年3月至2022年9月该院收治的90例乳腺癌放疗后皮损患者进行前瞻性研究,按照随机数字表法将其分为对照组和观察组各45例。对照组实施常规皮肤护理管理,观察组实施结构化皮肤护理管理,比较两组皮损严重程度评分、美国肿瘤放射治疗协作组(RTOG)急性放射损伤分级标准分级、生命质量[欧洲癌症研究与治疗组织生命质量测定量表(EORTC QLQ-C30)]评分和自护能力[自我护理能力量表(ESCA)]评分。结果:护理2、4周后,两组皮损严重程度评分均低于护理前,且观察组低于对照组,差异有统计学意义(P<0.05);护理后,两组1、2、4级RTOG分级占比比较,差异均无统计学意义(P>0.05);观察组3级RTOG分级占比为17.78%(8/45),低于对照组的37.78%(17/45),差异有统计意义(P<0.05);护理后,两组EORTC QLQ-C30评分均低于护理前,且观察组低于对照组,差异有统计学意义(P<0.05);护理后,两组自我概念、健康知识水平、自护责任感、自我护理技能等各项ESCA评分均高于护理前,且观察组高于对照组,差异有统计学意义(P<0.05)。结论:结构化皮肤护理管理应用于乳腺癌放疗后皮损患者,可减轻皮损严重程度,降低RTOG分级,提高生命质量和自护能力,效果优于常规皮肤护理管理。

Objective:To observe application effects of structured skin nursing management in patients with skin lesions after radiotherapy for breast cancer.Methods:A prospective study was conducted on 90 patients with skin lesions after radiotherapy for breast cancer admitted to this hospital from March 2020 to September 2022.According to the random number table method,they were divided into control group and observation group,45 cases in each group.The control group implemented routine skin nursing management,while the observation group was given the structured skin nursing management.The skin lesion severity scores before and after the nursing,the acute radiation injury grading standards of the Radiation Therapy Oncology Group(RTOG)after the nursing,the quality of life[European Organization for Research and Treatment of Cancer,quality of life questionnaire(EORTC QLQ-C30)]score,and the self-care ability[exercise of self-care agency scale(ESCA)]score were compared between the two groups.Results:After 2 and 4 weeks of nursing,the skin lesion severity scores of the two groups were lower than those before the nursing,those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After the nursing,there were no statistically significant differences in the proportion of RTOG grade 1,2,and 4 between the two groups(P>0.05);and the proportion of grade 3 RTOG in the observation group was 17.78%(8/45),which was lower than 37.78%(17/45)in the control group,and the difference was statistically significant(P<0.05).After the nursing,the EORTC QLQ-C30 scores of the two groups were lower than those before the nursing,that in the observation group was lower than that in the control group,and the differences were statistically significant(P<0.05).Further,After the nursing,the ESCA scores of self-concept,health knowledge level,self-care responsibility and self-care skills in the two groups were higher than those before the nursing,those in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusions:The structured skin nursing management in the patients with skin lesions after radiotherapy for breast cancer can reduce the severity of skin lesions,reduce the RTOG grading,and improve the quality of life and the self-care ability.Moreover,it is superior to the routine skin nursing management.