结直肠癌患者卡培他滨化疗相关不良反应的风险评估及风险预测模型构建

目的探究结直肠癌(CRC)患者卡培他滨化疗诱导不良反应(CIAEs)的危险因素并构建CIAEs发生的风险预测模型。方法回顾性收集2021年1月至2023年12月于温州医科大学附属第一医院接受卡培他滨片治疗的根治性术后CRC患者临床资料。根据是否出现CIAEs分为CIAEs和非CIAEs(NCIAEs)组。采用t检验和卡方检验筛选差异变量。多因素Logistic回归探究CRC患者发生CIAEs的独立影响因素,并使用R软件构建CRC患者CIAEs风险预测模型。采用受试者工作特征曲线分析、校准曲线和决策曲线评估CIAEs发生风险预测模型的预测能力、校准能力和临床净获益。结果本研究共纳入253例接受卡培他滨片治疗的根治性术后CRC患者,201例发生CIAEs,恶心呕吐(69.96%)发生率最高。多因素Logistic回归结果表明,年龄[OR=3.018,95%CI(1.404,6.487),P=0.005]、预后营养指数[OR=0.129,95%CI(0.06,0.278),P<0.001]和系统炎症指数[OR=4.074,95%CI(1.316,12.615),P=0.015]是CRC患者发生CIAEs的独立影响因素。本研究所构建的CIAEs发生风险预测模型具有良好的预测能力、校准能力和临床净获益。结论CIAEs发生风险预测模型可用于CRC患者CIAEs的个体化预测,是预防CIAEs和护理管理过程中一种简单实用的工具。

管理化疗不良反应,试试这3招

化学疗法(简称化疗),作为常见的癌症治疗手段之一,是使用强效药物"攻击并消灭"癌细胞.对许多癌症患者来说,化疗是控制疾病进展、延长生命的有效治疗方法.然而,化疗的不良反应会对患者的生活质量造成巨大影响.因此,管理化疗的不良反应不仅可以提高治疗效果,而且可以提高患者的生活质量.

艾迪注射液联合化学药物治疗晚期非小细胞肺癌20例

目的:比较艾迪注射液联合化学药物治疗与单纯化学药物治疗对晚期非小细胞肺癌的疗效及不良反应。方法:观察组采用NP方案加艾迪注射液,对照组单用NP方案。结果:观察组比对照组有效率高,但差异无显著性(P>0.05);而化学药物治疗不良反应低于对照组,差异有统计学意义(P<0.05);生活质量改善观察组优于对照组。结论:艾迪注射液治疗晚期非小细胞肺癌中能显著减轻化学药物治疗引起的不良反应,对骨髓有保护作用,患者生活质量改善。

对中晚期肺癌患者进行系统性护理的效果研究

目的 :探讨对中晚期肺癌患者进行系统性护理的临床效果。方法 :对2012年12月~2014年12月期间在浦口中心医院肿瘤科接受化疗的76例肺癌患者的临床资料进行回顾性研究。将这76例患者随机分为对照组和观察组,每组各有38例患者。对这76例患者均进行化疗治疗。同时,对对照组患者进行常规护理,对观察组患者进行系统性护理。然后,比较两组患者疼痛的缓解率及其各项化疗不良反应的发生率。结果 :观察组患者疼痛的缓解率明显高于对照组患者,二者相比差异具有显著性(P<0.05)。观察组患者各项化疗不良反应的发生率均明显低于对照组患者,二者相比差异具有显著性(P<0.05)。结论 :对中晚期肺癌患者进行系统性护理的效果显著,可明显缓解其疼痛的程度,降低其化疗不良反应的发生率。此护理方法值得在临床上推广使用。

Therapeutic observation of grain-sized moxibustion for chemotherapy-induced myelosuppression for non-small cell lung cancer

Objective: To observe the clinical efficacy of grain-sized moxibustion in treating chemotherapy-induced myelosuppression for non-small cell lung cancer (NSCLC) and its effect on quality of life (QOL). Methods: Eighty NSCLC patients admitted to the Inpatient Department of Zhejiang Cancer Hospital between September 2016 and March 2018 were recruited and divided into an observation group and a control group by random number method, with 40 cases in each group. The two groups both received chemotherapy with paclitaxel plus cisplatin (TP regimen). The control group received oral administration of leucogen tablets starting from the first day of chemotherapy, 20 mg each time, three times a day, for consecutive 14 d;the observation group was additionally given grain-sized moxibustion, once a day, five days per week at a two-day interval, until the fourteenth day. The myelosuppression severity was observed and compared between the two groups prior to chemotherapy, at the 3rd, 7th and 14th days of chemotherapy;the QOL in the two groups was evaluated before chemotherapy, at the 14th and 21st days of chemotherapy. Results: Regarding myelosuppression, the peripheral blood indicators increased significantly at the 3rd day of chemotherapy in both groups (P<0.05 or P<0.01);at the 7th and 14th days of chemotherapy, the peripheral blood indicators presented a decreasing tendency in the two groups, but the level in the observation group was still significantly higher than that before chemotherapy (P<0.01);at the 3rd, 7th and 14th days of chemotherapy, the peripheral blood indicators in the observation group were higher than those in the control group (P<0.05 or P<0.01);the occurrence rate of myelosuppression in the observation group was significantly lower than that in the control group (P<0.01). The QOL score in the observation group was markedly higher than that in the control group at the 14th and 21st days of chemotherapy (both P<0.05). Conclusion: Grain-sized moxibustion can effectively improve myelosuppression after chemotherapy for NSCLC, reducing its occurrence and enhancing the patient's QOL.

Scalp acupuncture combined with body acupuncture for 32 cancer cases with intractable hiccups after radiochemotherapy

Objective： To observe the therapeutic effect of scalp acupuncture combined with body acupuncture in treating cancer patients with intractable hiccups after radiochemotherapy. Methods; Thirty-two cancer patients with intractable hiccups after radiochemotherapy who met the inclusion criteria were selected. The Line 2 Lateral to Forehead （MS 3） of scalp stimulation areas as well as body acupoints including Danzhong （CV 17）, Zhongwan （CV 12）, bilateral Cuanzhu （BL 2）, Neiguan （PC 6）, Zusanli （ST 36） and Taichong （LR 3） were punctured. The treatment was given once a day, 5 treatments constituted a course, and the efficacy was evaluated after 2 treatment courses. Results： After 10 treatments, 26 cases were cured, 4 cases were improved, and 2 cases were invalid, and the total effective rate was 93.8%. Conclusion： Scalp acupuncture combined with body acupuncture in treating intractable hiccups in cancer patients after radiochemotherapy has reliable therapeutic effect, and it is easy-to-operate and can effectively alleviate the suffering of patients with less adverse reaction.