摘要
目的:观察头颈部恶性肿瘤放疗患者营养支持、心理干预及人文照护综合治疗的疗效。方法:选择2014年8月至2017年2月我科收住的诊断明确的头颈部恶性肿瘤患者100例,随机分为对照组50例,放疗时给予对症治疗;治疗组50例,放疗前给予营养筛查评估,放疗同期给予目标营养支持治疗、心理干预及人文照护。结果:对照组中重度营养不良47例,发生率为94%,其中重度营养不良31例,发生率为62%,治疗组中重度营养不良17例,发生率为34%,其中重度营养不良2例,发生率为4%;急性放射性口腔炎及皮炎Ⅲ、Ⅳ级发生率治疗组低于对照组,差异有统计学意义(P<0.05);对照组Ⅲ、Ⅳ级骨髓抑制发生率为66%,其中Ⅲ级骨髓抑制发生率为89%,治疗组Ⅲ级骨髓抑制发生率为26%,未发现Ⅳ级骨髓抑制;放疗2~3周后两组CRP、水电解质、血清白蛋白、生存质量比较均有显著性差异,差异均有统计学意义(P<0.05)。结论:合理的目标营养支持能有效改善头颈部恶性肿瘤患者的营养状况,联合心理干预、人文照护能明显减轻头颈部恶性肿瘤患者放疗不良反应,提高放疗完成率及其生活质量,值得临床应用。
Objective：To observe the therapeutic effect of nutritional support for the treatment of humanistic care in patients with head and neck tumor radiation therapy. Methods ： Select the 100 cases of head and neck tumors that were identified by my department from August 2014 to February 2017, and randomly divided into a control group of 50 patients. In the treatment group ,50 cases of radiotherapy were evaluated for nutritional screening, psychological assess- ment,treatment of target nutrition support treatment, psychotherapy and humanistic care. Results： In control group, there were 47 cases of severe malnutrition,the incidence was 94% ,31 cases of severe malnutrition, the incidence rate was 62%. In treatment group there were 17 cases of severe malnutrition,the incidence rate was 34% ,2 cases of severe malnutrition, the incidence rate was 4%. Incidence of acute radioactive stomatitis and dermatitis III - 1V level the treatment group is lower than the control group, the differences were statistically significant （ P 〈 0.05 ）. In control group III - IV degree of bone marrow suppression rate was 66% ,the third degree of bone marrow suppression rate was 89% , the treatment group III myelosuppression occurred in 26% , did not find the degree of myelosuppression. After radiotherapy 2 - 3 weeks two groups of CRP, water electrolyte, serum albumin, quality of life were significantly differ- ent, the differences were statistically significant （ P 〈 0.05 ）. Conclusion ： The goal of reasonable nutrition support can effectively improve the nutritional status of head and neck cancer patients, psychological intervention, humanistic care can reduce the patients with head and neck cancer radiotherapy side effects,improve radiation effeciency and quality of life, is worth wide application in the clinical practice.
出处
《现代肿瘤医学》
CAS
2017年第24期3966-3970,共5页
Journal of Modern Oncology
基金
陕西省中医管理局中医药科研课题(编号:15JC017)
关键词
头颈部恶性肿瘤
放疗
目标营养支持
心理治疗
人文照护
head and neck cancer,radiotherapy,target nutritional support,psychotherapy,humanistic care
