不同温度的间断性手足低温疗法对乳腺癌化疗致外周神经毒性的干预效果

Intervention effect of intermittent hand⁃foot hypothermia therapy with different temperatures on chemotherapy⁃induced peripheral neurotoxicity for breast cancer

目的:探讨不同温度的间断性手足低温疗法对乳腺癌病人紫杉类药物诱导的外周神经毒性(CIPN)、手足综合征(HFS)和生活质量的干预效果。方法:选取2022年8月—2023年5月在唐山市某三级甲等医院收治的72例乳腺癌病人作为研究对象,随机分为试验1组和试验2组,每组36例。两组化疗期间均给予间断性手足低温疗法,每次输注紫杉类药物前后15 min,试验1组与试验2组分别佩戴-10~0℃与-30~-20℃冷冻手套和脚套,于干预前、干预2、4、6个周期后测评CIPN、HFS和生活质量的差异性及低温疗法的耐受性和安全性。结果:试验2组在干预4、6个周期后CIPN和HFS发生率及严重程度均低于试验1组,躯体功能、情绪功能、社交功能、总体健康状况、疲劳、失眠评分差值均低于试验1组,差异均有统计学意义(均P<0.05)。两组病人均无因不能耐受而退出试验者。结论:温度较低的间断性手足低温疗法更能有效预防CIPN和HFS发生及严重程度,提高病人生活质量。

Objective:To evaluate the effect on chemotherapy-induced peripheral neurotoxicity(CIPN),hand and foot syndrome(HFS),and quality of life in breast cancer patients treated with intermittent hand and foot hypothermia at different temperatures.Methods:A total of 72 patients with breast cancer admitted to a tertiary grade A hospital in Tangshan city from Aug 2022 to May 2023 were selected as research subjects and randomly divided into study groups 1 and 2,with 36 cases in each group.During 15 minutes chemotherapy,before and after each infusion of taxoid drugs,both groups received intermittent hand and foot hypothermia therapy.Study group 1 and study group 2 wore-10~0℃and-30~20℃freezing gloves and foot covers,respectively.Differences in CIPN,HFS and quality of life,and hypothermia tolerability and safety were evaluated before intervention and after second,fourth and sixth cycles.Results:Frequency and severity of CIPN and HFS in study group 2 were lower than those in study group 1 after 4 and 6 cycles of intervention,and scores of physical function,emotional function,social function,general health,fatigue and insomnia were lower than those in study group 1,with statistical significance(P<0.05).There were no withdrawals from the study due to intolerance in either group.Conclusion:Intermittent low-temperature hand-foot hypothermia can effectively prevent the occurrence and severity of CIPN and HFS and improve patients′quality of life.