渐进式肌肉放松训练缓解乳腺癌化疗期恶心呕吐的效果

目的探讨渐进式肌肉放松训练对缓解乳腺癌化疗所致恶心呕吐的治疗效果。方法选取2017年1—6月收治于武汉大学人民医院乳腺甲状腺外科,行表阿霉素联合环磷酰胺(EC)方案化疗的乳腺癌术后患者68例,随机分为观察组和对照组各34例。对照组给予托烷司琼注射液、地塞米松止吐治疗;观察组在此基础上指导患者进行渐进式肌肉放松训练。采用MASCCA止吐评价工具比较两组患者化疗后24 h内及4 d后恶心、呕吐的发生情况。结果两组患者化疗后急性恶心、呕吐发生率及延迟性恶心发生率比较,差异均无统计学意义(P 0. 05);观察组患者延迟性呕吐发生率及呕吐频次明显低于对照组,恶心缓解率明显高于对照组,差异有统计学意义(P 0. 05)。结论渐进式肌肉放松训练能显著降低乳腺癌EC方案化疗后延迟性呕吐的发生率及呕吐频次,提高恶心缓解率,对于提高患者化疗依从性有积极促进作用。     

分级管理方案在乳腺癌患者化疗所致恶心呕吐中的应用

目的 探讨分级管理方案在乳腺癌患者化疗所致恶心呕吐（chemotherapy induced nausea and vomiting,CINV）中的应用效果。方法 采取整群抽样法抽取试验组及对照组各158例,试验组给予CINV分级管理方案,对照组给予CINV常规护理,比较两组CINV发生情况及CINV对生活质量的影响。 结果 试验组接受高度、中度致吐风险化疗方案的患者,CINV发生情况明显低于对照组（P<0.05）,而接受低度致吐风险化疗方案的两组患者,CINV发生情况差异无统计学意义（P>0.05）;试验组接受高度、中度及低度致吐风险化疗方案的患者,呕吐生活功能指数量表评分均明显高于对照组（P<0.05）。 结论 CINV分级管理方案总体上可降低CINV的发生率及等级,并降低CINV对患者生活质量的影响。     

阿瑞匹坦三联用药预防乳腺癌蒽环类药物联合环磷酰胺化疗致恶心呕吐的效果观察

目的评估阿瑞匹坦、托烷司琼、地塞米松三联方案预防乳腺癌蒽环类药物联合环磷酰胺化疗致恶心呕吐的效果及安全性。方法选择2014年1月—2015年6月沈阳军区总医院肿瘤科收治的接收蒽环类药物(表柔比星或多柔比星)联合环磷酰胺化疗的乳腺癌患者62例,根据预防化疗相关性恶心呕吐(chemotherapy-induced nausea and vomiting,CINV)方案的不同分为试验组和对照组各31例。两组常规化疗,对照组给予托烷司琼、地塞米松二联方案预防CINV,试验组在对照组治疗基础上加用阿瑞匹坦。观察两组化疗后急性期(0~24 h)及延迟期(24~120 h)预防恶心呕吐的效果及不良反应发生情况。结果化疗后呕吐急性期内两组CR率和有效控制率比较差异均无统计学意义(Z=-1.579,P=0.114);呕吐延迟期内试验组CR率和有效控制率均高于对照组,差异均有统计学意义(Z=-2.196,P=0.028)。两组不良反应发生率比较差异无统计学意义(P0.05),且不良反应均较轻微,患者可耐受。结论阿瑞匹坦三联方案对乳腺癌蒽环类药物联合环磷酰胺化疗致延迟性呕吐的疗效确切,且不良反应轻微,患者可耐受。     

盐酸帕洛诺司琼治疗高致吐性化疗药物所致恶心、呕吐的临床观察

目的 观察盐酸帕洛诺司琼治疗高致吐性化疗药物所致恶心、呕吐的疗效.方法 对68例接受高致吐性化疗药物治疗的恶性肿瘤患者随机分为2组,观察组35例用盐酸帕洛诺司琼联合地塞米松,对照组33例用昂丹司琼联合地塞米松.结果 2组急性期呕吐的完全缓解率差异无统计学意义(P＞0.05),观察组对延迟期呕吐的完全缓解率为57.1％( 20/35),高于对照组33.3％( 12/33),差异具有统计学意义(P＜0.05).观察组对患者的食欲、精神状态及与人交往方面的改善优于对照组[生活质量评分:观察组分别为(3.85±0.95)、(4.01±1.91)、(4.03±0.91)分,对照组分别为(2.69±0.94)、(3.14±0.90)、(3.25±0.82)分,P均＜0.05].2组不良反应主要为便秘、腹部不适等,耐受性好.结论 盐酸帕洛诺司琼联合地塞米松能有效治疗高致吐性化疗药物所致的急性期和延迟期恶心、呕吐,能改善化疗患者的生活质量.     

全程管理模式在乳腺癌患者化疗所致恶心呕吐中的应用

目的探讨全程规范化护理管理模式在乳腺癌患者化疗所致恶心呕吐(CINV)中的应用效果。方法将172例乳腺癌患者按入院时间分为对照组87例,观察组85例。对照组采用常规护理管理方法,观察组实施全程规范化管理模式。结果观察组化疗所致的恶心呕吐的发生频率、严重程度明显低于对照组(P<0.05);观察组患者化疗后卡式行为状态评分(KPS)明显高于对照组(P<0.05)。结论全程规范化护理管理模式可降低化疗所致恶心呕吐的发生率,减轻CINV的严重程度,并可降低CINV对患者生活质量的影响。     

渐进性肌肉放松训练对肺癌化疗病人恶心呕吐、癌因性疲乏及负性情绪的影响研究

[目的]探讨渐进性肌肉放松训练对肺癌化疗病人恶心呕吐、癌因性疲乏及负性情绪的影响。[方法]将50例肺癌化疗病人按照随机数字表法分为两组,对照组25例给予常规护理干预,观察组25例在对照组的基础上给予渐进性肌肉放松训练。干预3周后比较两组病人的焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分、Piper疲乏量表(PFS)评分以及恶心呕吐发生率。[结果]3周后,观察组病人恶心呕吐发生率为16.00%,明显低于对照组的44.00%,差异有统计学意义(P0.05);观察组SAS、SDS评分均明显低于对照组,差异均有统计学意义(P0.05);观察组PFS总分以及认知、感觉、情感、行为得分均明显低于对照组,差异均有统计学意义(P0.05)。[结论]在常规护理干预的基础上加用渐进性肌肉放松训练,可明显减轻肺癌化疗病人的负性情绪及癌因性疲乏,且减少了恶心呕吐的发生。     

无呕管理模式在乳腺癌化疗所致恶心呕吐中的应用

目的分析全程规范无呕管理模式在乳腺癌化疗所致恶心呕吐(chemotherapy induced nausea and vomiting,CINV)中的应用效果。方法采取整群抽样法抽取220例于2018年3～12月在本科行乳腺癌辅助化疗的患者为研究对象,将其分为对照组和观察组,对对照组实施化疗的常规护理方案,对观察组实施全程规范无呕管理措施,观察并比较两组患者恶心呕吐(CINV)的发生情况及对生活质量的影响。结果观察组患者恶心呕吐的情况较对照组明显减轻(P0.05),同时生活质量评分也明显高于对照组(P0.05)。结论全程规范无呕管理模式可明显降低CINV的发生率和严重程度,减轻CINV对患者生活质量的影响,提高患者对护理工作的满意度。     

果皮面罩吸入对顺铂化疗患者恶心呕吐的影响

目的探讨果皮面罩吸入对顺铂化疗患者恶心呕吐的影响。方法选取2019年4月—2020年4月在兴化市人民医院肿瘤科接受含顺铂化疗方案治疗的120例患者。随机将其分成两组,对照组和观察组各60例。对照组给予常规护理,观察组在常规护理基础上根据患者喜好选择橙子或者柠檬制成的果皮面罩进行芳香吸入,对比不同护理模式对患者恶心呕吐的影响。结果两组患者急性期、延迟期的恶心、呕吐发生率比较差异无统计学意义(P0.05);两组患者急性期呕吐频次比较差异无统计学意义(P0.05);观察组患者在延迟期呕吐频次明显优于对照组(P0.05);观察组患者急性期、延迟期恶心程度明显优于对照组(P0.05)。结论果皮面罩吸入可以改善顺铂化疗患者恶心呕吐的症状,无创安全、经济实用,适合临床推广。     

沙利度胺联合盐酸托烷司琼对转移性乳腺癌GP方案化疗所致恶心呕吐的疗效观察

探讨沙利度胺联合盐酸托烷司琼对转移性乳腺癌使用高致吐性化疗药物所致的恶心呕吐的预防作用。方法将2011年1月至2013年7月收治的81例转移性乳腺癌患者随机分成实验组（41例）和对照组（40例）。均采用GP方案：吉西他滨1 000 mg/m2,第1、8天;顺铂75 mg/m2,第1天。对照组用盐酸托烷司琼注射液5 mg,化疗前30 min静脉推注。实验组在对照组的基础上加用沙利度胺片25 mg口服,2次/d,d1~d8。结果实验组和对照组的急性恶心的有效率分别为95.1%和95.0%,急性呕吐的有效率分别为80.5%和77.5%,两组差异均无统计学意义（P均〉0.05）。实验组和对照组化疗所致延迟性恶心的有效率分别为58.5%和22.5%,延迟性呕吐的有效率78.0%和52.5%,实验组均高于对照组（P均〈0.05）。实验组和对照组的不良反应可耐受,嗜睡、乏力、便秘、头痛和皮疹的发生率差异均无统计学意义（P均〉0.05）。结论沙利度胺联合盐酸托烷司琼治疗能有效预防高致吐性药物引起的延迟性恶心呕吐,不良反应轻微。     

电子止吐仪联合昂丹司琼预防乳腺癌延迟性化疗相关恶心、呕吐的效果观察

[目的]观察电子止吐仪联合昂丹司琼预防乳腺癌延迟性化疗相关恶心、呕吐的疗效。[方法]将63例接受中、高致吐性化疗药物治疗的乳腺癌病人分为两组,试验组(31例)应用电子止吐仪联合昂丹司琼治疗,对照组(32例)应用昂丹司琼治疗,观察并记录两组乳腺癌病人化疗结束后第1天~第3天的恶心、呕吐情况。[结果]试验组和对照组在第1天~第3天呕吐控制有效率分别为64.5%和28.1%、74.2%和50.0%、96.8%和87.5%,呕吐控制情况第1天、第2天比较差异有统计学意义(P0.05),第3天比较差异无统计学意义(P0.05)。试验组和对照组在第1天~第3天恶心控制有效率分别为51.6%和25.0%、80.6%和56.3%、87.1%和81.3%,恶心控制情况第1天、第2天比较差异有统计学意义(P0.05),第3天比较差异无统计学意义(P0.05)。且两组的不良反应轻微,主要有头晕、头痛、乏力、便秘等,不良反应发生率差异无统计学意义。[结论]电子止吐仪联合昂丹司琼预防乳腺癌延迟性化疗相关恶心、呕吐的作用优于单用昂丹司琼,且不良反应可以耐受。     

耳穴压豆联合昂丹司琼改善宫颈癌术后化疗患者恶心、呕吐反应发生情况的效果

目的探究耳穴压豆联合昂丹司琼改善宫颈癌术后化疗患者恶心、呕吐反应发生情况的效果。方法选取我院2016年2月至2019年2月的宫颈癌术后化疗患者80例,按照随机数字表法将其分为对照组和观察组,各40例。对照组给予昂丹司琼治疗,观察组给予耳穴压豆联合昂丹司琼治疗。比较两组疗效、呕吐次数、恶心等级、恶心及呕吐反应缓解时间及化疗应激指标。结果第1天,两组的治疗总有效率无显著差异(P>0.05);第2、3、4天,观察组的治疗总有效率均显著高于对照组(P<0.05)。第2、3、4天,观察组的呕吐次数、恶心等级均优于对照组(P<0.05);第2、3、4天,观察组的呕吐次数、恶心等级均优于第1天(P<0.05)。观察组的恶心、呕吐反应缓解时间均显著短于对照组(P<0.05)。观察组的胰岛素水平高于照组,空腹血糖水平、HAMA评分、NRS及HAMD均低于对照组(P<0.05)。结论耳穴压豆联合昂丹司琼治疗可降低宫颈癌术后化疗患者的恶心、呕吐反应发生率,促进恶心与呕吐反应缓解,改善化疗应激指标。     

A pilot study of a relaxation technique for management of nausea and vomiting in patients receiving cancer chemotherapy

This study was designed to determine the effect of a progressive muscle relaxation intervention on nausea and vomiting associated with anticancer chemotherapy. Subjects were 30 hematology patients who were hospitalized and received chemotherapy treatment at a large hospital in the interior of S?o Paulo, Brazil. The results indicated that progressive muscle relaxation lead to statistically significant changes in physiological and muscle conditions and in nausea and vomiting levels. Therefore, this relaxation technique may be an effective nursing intervention method to allay or alleviate nausea and vomiting in patients receiving chemotherapy. For future studies, we suggest using a control group, a homogeneous sample in terms of antiemetic and chemotherapy type and dosage, and the longitudinal following of subjects during chemotherapy.     

国产盐酸帕洛诺司琼注射液预防化疗所致恶心呕吐的随机对照研究

目的评价盐酸帕洛诺司琼预防高度催吐危险的化疗方案所致恶心、呕吐的疗效和安全性。方法将符合纳入标准的恶性肿瘤患者随机分入AB组和BA组,于化疗前30min缓慢静推盐酸帕洛诺司琼或盐酸托烷司琼。观察化疗后5d内恶心、呕吐情况,以及不良反应。结果共纳入24例患者,可评价18例。2种药物对恶心、急性呕吐的完全控制率及有效控制率,以及对迟发性呕吐的完全控制率比较,无显著差异,而盐酸帕洛诺司琼对迟发性呕吐的有效控制率显著高于盐酸托烷司琼。2种药物不良反应较少且程度较轻。结论盐酸帕洛诺司琼预防高度催吐危险的化疗方案所致恶心和急性呕吐的疗效与盐酸托烷司琼相当,但预防迟发性呕吐的疗效优于盐酸托烷司琼,且不良反应发生率低、程度轻。     

The effectiveness of progressive muscle relaxation training in managing chemotherapy-induced nausea and vomiting in Chinese breast cancer patients: a randomised controlled trial

This study was a randomised controlled trial designed to assess the effectiveness of progressive muscle relaxation training (PMRT) in the clinical management of chemotherapy-related nausea and vomiting as an adjuvant intervention to accompany pharmacological antiemetic treatment (metoclopramide and dexamethasone i.v.). Seventy-one chemotherapy-naive breast cancer patients of an outpatient oncology unit of a university hospital in Hong Kong participated, with 38 subjects randomised to the experimental group and 33 to the control group. The intervention included the use of PMRT 1 h before chemotherapy was administered and daily thereafter for another 5 days (for a total of six PMRT sessions). Each session lasted for 25 min and was followed by 5 min of imagery techniques. The instruments used for data collection included the Chinese versions of the Profile of Mood States and the State-Trait Anxiety Inventory (measured before chemotherapy and then at day 7 and day 14 after chemotherapy), and the Morrow Assessment of Nausea and Vomiting Scale, which was used daily for the first 7 post-chemotherapy days. The use of PMRT considerably decreased the duration of nausea and vomiting in the experimental group compared with the control group ( P<0.05), whereas there were trends toward a lower frequency of nausea and vomiting ( P=0.07 and P=0.08 respectively). Neither nausea nor vomiting differed in intensity between the two groups. The significant effects were mainly evident on the first 4 post-chemotherapy days, when differences were statistically significant. Although there was a significantly less severe overall mood disturbance in the experimental group over time ( P<0.05), this did not apply in the case of anxiety. Such findings suggest that PMRT is a useful adjuvant technique to complement antiemetics for chemotherapy-induced nausea and vomiting and that incorporation of such interventions in the care plan can enhance the standards of care of cancer patients who experience side effects of chemotherapy.     

渐进性肌肉放松训练对肺癌脑转移患者生活质量的影响

目的探讨渐进性肌肉放松训练对肺癌脑转移患者生活质量的影响。方法选取苏州大学附属第一医院2017年9月至2019年2月收治的80例肺癌伴脑转移患者为研究对象,采用随机数字表法分成两组。对照组(40例)患者给予常规护理;观察组(40例)实施常规护理+渐进性肌肉放松训练。观察两组患者脑卒中患者神经功能缺损评估量表(NIHSS)、生活质量量表评分及护理满意度的变化。结果护理干预前两组患者NIHSS及生活质量量表评分差异均无统计学意义(P>0.05)。干预6周后,两组患者NIHSS评分均呈不同程度降低,但对照组干预前后NIHSS评分差异无统计学意义(P>0.05),而观察组明显低于对照组及干预前(P<0.05);观察组生活质量量表评分除社会/家庭状况方面,其他方面评分均较干预前及对照组高(P<0.05);观察组护理满意度(95.0%)较对照组(80.0%)高(P<0.05)。结论渐进性肌肉放松训练有助于改善肺癌脑转移患者NIHSS评分及生活质量,提高护理满意度。     

帕洛诺司琼对比托烷司琼在预防晚期肺癌恶性胸腔积液胸腔化疗所致恶心呕吐的疗效观察

目的评价帕洛诺司琼在预防晚期肺癌恶性胸腔积液胸腔化疗所致恶心止吐的疗效并与托烷司琼对比。方法46例晚期肺癌伴恶性胸腔积液需行顺铂胸腔化疗的患者随机分为实验组（帕洛诺司琼组,n=23）和对照组（托烷司琼组,n=23）,观察并比较两组病人预防恶心止吐的效果及不良反应。结果实验组和对照组的急性恶心有效控制率分别为87．0％和78．3％,急性呕吐有效控制率分别为73．9％和60．9％,两组相比无显著性差异（P〉0．05）;在迟发性恶心和呕吐有效控制率方面,帕洛诺司琼组分别为78．3％和69．6％,托烷司琼组分别为47．8％和34．8％,两者具有显著性差异（P〈0．05）。治疗期间有部分患者出现腹胀、便秘及头晕,两组相比无显著性差异（P〉0．05）。结论帕洛诺司琼与托烷司琼在预防晚期肺癌恶性胸腔积液患者行顺铂胸腔化疗所致急性恶心呕吐的疗效相当,但对于迟发性恶心呕吐帕洛诺司琼有更好的效果。     

穴位按压及营养支持对实体瘤患者化疗期间生活质量及免疫的影响

目的研究穴位按压联合针对性营养支持对实体瘤患者化疗期间恶心呕吐症状、生活质量及免疫功能的影响。方法选取2018年1月至2019年1月于该院就诊并接受化疗的实体瘤患者100例作为研究对象,按照随机数字表法分为对照组和观察组,每组50例。对照组患者给予常规干预,观察组患者在对照组的基础上进行穴位按压及针对性营养支持。对两组患者化疗后恶心呕吐症状、生活质量及免疫功能进行对比。结果观察组患者在化疗后,不同程度恶心呕吐的发生率明显低于对照组患者,差异有统计学意义(P<0.05)。在化疗后的生活质量评分中,躯体功能、角色功能、社会功能和整体生命质量指标观察组评分结果均优于对照组,差异均有统计学意义(P<0.05)。治疗后观察免疫功能指标,观察组治疗后CD3^+、CD4^+、CD4^+/CD8^+、自然杀伤细胞数量变化优于对照组,差异均有统计学意义(P<0.05)。结论穴位按压联合针对性营养支持可以有效缓解实体瘤患者化疗所导致的恶心呕吐症状,并能在一定程度上提高患者的生活质量及免疫功能。     

Effects of coping style and relaxation on cancer chemotherapy side effects and emotional responses

This study was designed to determine (a) the relationship of coping style to cancer chemotherapy side effects and (b) whether coping style moderated the impact of a relaxation intervention on anxiety, depression, and nausea associated with chemotherapy. Forty-eight cancer patients were assigned randomly to receive either progressive muscle relaxation training before chemotherapy (experimental group) or standard care (control group). Spearman correlations indicated that a "blunting" or distraction-oriented coping style was associated with less anticipatory anxiety, less depression, and less nausea during and after chemotherapy. Spearman correlations also indicated that a "monitoring" or information-gathering coping style was associated with more anticipatory anxiety, and more nausea before and during chemotherapy. Although there was a significant effect of the relaxation intervention on posttreatment nausea, there were no other between-group differences. The results did suggest, however, that relaxation was effective in reducing anticipatory anxiety among "blunters," but not "monitors," perhaps because relaxation is a distraction strategy and therefore is consistent with a blunting coping style. The effects of coping and relaxation on pretreatment anxiety may have important implications, because anxiety is a key factor in classic conditioning models of anticipatory nausea and vomiting.     

The impact of chemotherapy-induced nausea and vomiting on health-related quality of life

Goal of work The objectives of this prospective observational study were to estimate the frequency of patients who reported an impact of chemotherapy-induced nausea and vomiting (CINV) on their daily life and to evaluate the determinants of such an impact. Materials and methods Adult cancer patients at seven Italian oncology centers who were receiving cisplatin-containing regimens reported incidence and intensity of CINV for eight consecutive days in a diary and completed a Functional Living Index for Emesis (FLIE) questionnaire. Main results Overall, 34% of patients reported vomiting and 62% reported nausea after chemotherapy. On days 1 to 5 after receiving chemotherapy, 67% of patients who had at least one emetic episode and 77% of those who suffered from at least mild nausea experienced an impact on their daily activities as measured on the FLIE questionnaire. More than 90% of all patients with both acute and delayed nausea or vomiting reported an impact on their daily life. Both acute and delayed vomiting contributed in similar measure to impact daily life; however, the importance of delayed nausea was greater than that of acute nausea. Conclusions Despite antiemetic prophylaxis, CINV is still prevalent and often impacts the daily life of patients in Italy, especially in the delayed phase. The duration more than the severity seems to be responsible for the impact of CINV on the patients’ daily lives.     

健康信念教育联合多维护理干预对胰腺癌化疗患者自我效能与不良反应的影响

目的探讨健康信念教育联合多维护理干预对胰腺癌化疗患者自我效能与不良反应的影响。方法选取2017年4月至2019年4月我院收治的胰腺癌化疗患者100例为研究对象,将其随机等分为对照组和观察组,对照组采用常规护理,观察组在对照组基础上实施健康信念教育联合多维护理干预。比较两组患者自我效能水平与不良反应发生率。结果观察组自我效能评分高于对照组(P<0.05);观察组癌痛不适、恶心呕吐、腹胀便秘、口腔炎及腹泻发生率低于对照组(P<0.05)。结论健康信念教育联合多维护理干预在胰腺癌化疗患者中应用可增强自我效能,减少不良反应发生率。