摘要
目的 观察延续性护理对鼻咽癌患者放疗所致颅底骨坏死手术的干预效果。方法 选择广西贵港市人民医院2019年1月—2020年12月收治的60例鼻咽癌放化疗所致颅底骨坏死患者。所有患者均开展鼻内镜颅底骨坏死清除+黏膜瓣修复术治疗。术后对所有患者开展延续性护理干预,分析干预前后心理弹性变化、自我护理能力、生活质量、并发症发生率、复发率、生存率。此外,通过匹茨堡睡眠质量指数(PSQI)评估患者干预前后睡眠质量。结果 干预后患者的坚韧、自强及乐观评分分别为(45.10±6.20)分、(30.04±3.25)分及(14.79±1.24)分,均高于干预前的(30.12±4.23)分、(22.06±2.17)分及(8.49±0.35)分(均P<0.001)。干预后患者的健康认知、自我概念、自我责任感以及自护技能评分分别为(47.69±6.24)分、(33.15±2.84)分、(32.51±3.45)分及(43.05±4.18)分,均高于干预前的(34.29±3.39)分、(24.12±2.05)分、(22.83±2.16)分及(30.45±2.63)分(均P<0.001)。干预后患者的各项健康调查简表(SF-36)评分均高于干预前(均P<0.05)。并发症发生率、复发率以及生存率分别为5.00%、3.33%及95.00%。干预后患者的PSQI评分低于干预前,且睡眠障碍发生率低于干预前(均P<0.05)。结论 延续性护理应用于鼻咽癌患者放疗所致颅底骨坏死手术后的效果显著,可在一定程度上改善患者心理状态、自我护理能力、生活质量以及睡眠质量。
Objective To study the effect of continuous nursing on surgery of osteoradionecrosis of the skull base after radiotherapy for nasopharyngeal carcinoma.Methods 60 patients with osteoradionecrosis of the skull base after radiotherapy for nasopharyngeal carcinoma admitted to Guigang People's Hospital from January 2019 to December 2020 were selected.All patients were treated with nasal endoscopy for osteonecrosis of the skull base and mucosal flap repair.Continuous nursing intervention was carried out for all patients after operation,and changes in mental resilience before and after the intervention,self-care ability,quality of life,complication rates,recurrence rates and survival rates were analyzed.In addition,sleep quality before and after intervention was assessed by Pittsburgh Sleep Quality Index(PSQI).Results After intervention,the scores of tenacity,self-reliance and optimism were(45.10±6.20)points,(30.04±3.25)points,(14.79±1.24)points,respectively,which were all higher than those before intervention([30.12±4.23]points,[22.06±2.17]points,[8.49±0.35]points)(all P<0.001).After intervention,the scores of health cognition,self-concept,self-responsibility and self-care skills were(47.69±6.24)points,(33.15±2.84)points,(32.51±3.45)points,(43.05±4.18)points,respectively,which were all higher than those before intervention([34.29±3.39]points,[24.12±2.05]points,[22.83±2.16]points,[30.45±2.63]points)(all P<0.001).After intervention,all SF-36 scores were higher than those before intervention(all P<0.05).The complication rate,recurrence rate and survival rate were 5.00%,3.33%and 95.00%,respectively.In addition,the PSQI score and the incidence of sleep disorders were lower than those before intervention(all P<0.05).Conclusion Continuous nursing can significantly improve the psychological state,self-care ability and quality of life of patients who undergo surgery of osteoradionecrosis of the skull base after radiotherapy.
作者
李婷
吴家森
LI Ting;WU Jiasen(Department of Otolaryngology,Head and Neck Surgery,Guigang People's Hospital,Guigang 537100,Guangxi,China)
出处
《右江医学》
2023年第5期467-471,共5页
Chinese Youjiang Medical Journal
基金
贵港市科学研究与技术开发计划项目(贵科攻1908026[社自])。
关键词
鼻咽癌
延续性护理
放疗后复发
颅底骨坏死
nasopharyngeal carcinoma
continuous nursing
recurrence after radiotherapy
osteonecrosis of the skull base
