Search

The Influence of Psychological Intervention on Immune Function and Psychological State in Patients Undergoing Chemotherapy after Radical Operation of Colorectal Cancer

ObjectiveTo study the influence of psychological intervention on the immune function and psychological state in patients undergoing chemotherapy after radical operation of colorectal cancer. MethodSixty-four patients who underwent chemotherapy after eradicative resection of rectal cancer between August 2008 and August 2013 were randomly divided into control group and intervention group. Both the two groups of patients accepted conventional chemotherapy and nursing, while patients in the intervention group were also given psychological intervention. At the beginning of and 8 weeks after the therapy, self-evaluation of anxiety scale and depression self-rating scale were used to determine the psychological state (anxiety and depression) of patients in the two groups, and we evaluated the effect of psychological intervention. At the same time, the immune index and inflammatory cytokines were determined and compared between the two groups. ResultsBefore treatment, patients in both the two groups were accompanied by mild anxiety and depression. After psychological intervention, compared with the control group, anxiety and depression of patients in the intervention group were significantly alleviated (P<0.05). Before chemotherapy, patients in the two groups were not statistically different in the immune factor index (P>0.05). After chemotherapy, compared with the control group, natural killer cells, CD3+, CD4+, CD4+/CD8+, C-reactive protein, immunoglobulin (Ig) G, interleukin (IL)-10 level of the intervention group significantly increased (P<0.05), and IL-6 and tumor necrosis factor alpha expression decreased (P<0.05). CD8+, IgA and IgM were not significantly changed (P>0.05). ConclusionsPsychological intervention can alleviate anxiety and depression and improve the immune function in patients who undergo chemotherapy after radical operation of colorectal cancer, which is an effective auxiliary treatment.

唑来膦酸治疗恶性肿瘤骨转移患者不良反应的护理

目的　总结对恶性肿瘤骨转移患者应用唑来膦酸不良反应的护理经验，旨在为临床护理提供指导。 方法　对2011年6月－12月28例恶性肿瘤骨转移患者使用唑来膦酸治疗后所产生的发热、骨关节疼痛、消化道反应、低钙性抽搐、骨坏死及心动过缓等不良反应予以对症护理。 结果　治疗中部分患者出现不良反应：发热6例（21.4%），骨关节疼痛4例（14.3%），胃肠道反应4例（14.3% ），低钙性抽搐2例（7.1%），经对症治疗及护理均予缓解。 结论　唑来膦酸治疗恶性肿瘤骨转移过程中出现的相关并发症，只要采取积极对症的治疗护理措施均可控制。

经外周静脉置入中心静脉导管异位至锁骨下静脉成“8”字形复位一例

放射及化学治疗所致口腔黏膜炎的护理

口腔黏膜炎是放射及化学治疗常见的不良反应，而口腔黏膜炎引起的继发反应，是影响患者生活质量的重要原因，所以对于口腔黏膜炎的护理非常重要。本文对放射及化学治疗引起口腔黏膜炎的护理进行了总结，以便于临床工作中医护人员正确评估患者的口腔，同时能够及时给予患者最佳的护理措施，进而提高患者的生活质量。

肝素钠在外周静脉置入中心静脉导管堵塞再通中的应用

【摘要】　目的　通过肝素钠注射液抗凝的原理对外周静脉置入中心静脉导管（PICC）堵塞进行疏通，观察肝素钠在PICC导管堵塞再通中的应用效果。　方法　2009年5-10月对80例需化疗的肿瘤患者行PICC置管治疗，其中6例PICC导管堵塞， 将PICC导管接口的肝素帽更换为三通管，一接口连接吸好少量生理盐水的20 mL注射器，另一接口连接吸好肝素钠的5 mL注射器，利用导管内负压将肝素液吸进导管，反复抽吸进行疏通。　结果　6例PICC导管堵塞患者中有4例再通成功，2例失败予拔管；再通成功率为66.7%（4/6）。　结论　在患者使用PICC 的过程中，应采取积极、有效的措施预防导管堵塞；肝素钠在PICC导管堵塞再通中的应用有效，对临床有较大帮助。

胃癌术后下肢深静脉血栓形成的危险因素logistic回归分析及护理对策

目的分析胃癌术后下肢深静脉血栓形成的危险因素。 方法2007年10月－2012年10月采用前瞻性方法收集180例胃癌术后患者的基础信息及临床资料，包括患者年龄、性别、有无冠心病、是否使用止血药、有无既往静脉曲张史、围手术期有无感染、有无中心静脉置管，以非条件logistic回归分析方法分析相关的危险因素。 结果180例胃癌术后患者中40例出现下肢深静脉血栓，采用χ2检验进行单因素分析结果显示，年龄＞60岁、有冠心病史、使用止血药、既往有血栓史为下肢深静脉血栓形成的危险因素（P＜0.05）；多因素logistic回归分析结果提示年龄＞60岁[OR=3.712，95%CI（1.157，11.906），P=0.027]及使用止血药[OR=3.686，95%CI（1.407，25.197），P=0.042]是胃癌术后下肢血栓形成的独立危险因素。 结论高龄和早期使用止血药物的胃癌患者易出现下肢静脉血栓，除常规护理外，应更加密切观察患者变化及采取对应护理措施，尽量避免早期使用止血药物。

晚期宫颈癌患者介入术后不良反应的护理

目的　讨论化学疗法（化疗）栓塞术治疗晚期宫颈癌的护理措施。 方法　对2011年6月－2012年6月24例宫颈癌患者进行动脉化疗栓塞术后出现的不良反应及护理处置方法进行回顾与总结。 结果　术后患者肿瘤均出现不同程度缩小，近期病症得以控制；其术后引发的发热、消化道反应、阴道局部症状、骨髓抑制等不良反应，经对症处理后均缓解。 结论　介入化疗栓塞术是治疗中晚期宫颈癌的有效方法，其微创、安全、重复、有效等优点得到了广泛的认同，可提高患者生活质量，延长患者生存期。

平阳霉素结合无水乙醇介入治疗体表血管畸形的护理

目的 采用平阳霉素结合无水乙醇选择性治疗体表血管畸形，通过加强围手术期的护理，从而提高患者依从性及临床疗效。 方法 2005年5月-2008年8月对53例体表血管畸形患者，使用平阳霉素与碘化油的混悬液结合无水乙醇进行治疗。 结果 治愈32例， 治愈率为60.4%；好转19例， 占35.8%；无效2例，占3.8%。未发现显著的不良反应。 结论 选择性治疗体表血管畸形具有简便、疗效显著、微创的特点，在介入手术全程，给予有针对性的围手术期护理，可提高患者的依从性，有效预防并发症，促进患者早日康复。

提升职业素养确保优质护理服务持续发展

【摘要】　通过对护理概念、护理内涵阐述与探讨，提出注重护士职业素养、职业道德与人文精神的培养，及加强其素质教育，充分明确优质护理的内涵，是确保优质护理服务持续改进、持续发展的重要方法。优质护理服务除了加大护理人力资源配置、改变排班模式、绩效考核等，其重点还应提高和调动护士的主观能动性，全面提升护士职业素养。

Effect of self-care and self-efficacy intervention in improving the quality of life of patients undergoing chemotherapy after gastric cancer surgery

Objective To investigate the influence of self-care and self-efficacy intervention on the quality of life of patients undergoing chemotherapy after surgery for gastric cancer. Methods Sixty-four patients undergoing chemotherapy after gastric cancer surgery between July 2014 and February 2015 were selected as the study subjects. According the sequence of admission, they were divided into intervention group (n=34) and control group (n=30). Patients in the control group accepted conventional care, while those in the intervention group received self-efficacy and self-care interventions. The scores of General Self-efficacy Scale (GCES), Exercise of Self-care Agency (ESCA), and Quality of Life Instruments for Cancer Patients-Stomach Cancer (QLICP-ST) were compared between the two groups before and after intervention. Results After intervention, GCES scores of the intervention group and the control group were respectively (30.08±4.21) and (20.78±4.58) points; the total scores of ESCA were respectively (132.30±14.81) and (92.45±13.23) points; and the total scores of QLICP-ST were respectively (75.96±9.41) and (56.77±10.32) points. All the above differences between the two groups were significant (P<0.05). Conclusion Self-care and self-efficacy intervention can improve self-care ability and self-efficacy, and improve the quality of life of patients undergoing chemotherapy after gastric cancer surgery.