低位晚期直肠癌患者术前新辅助放化疗的临床观察及护理

目的探讨低位晚期直肠癌术前接受新辅助放化疗的毒副反应及护理措施。方法本院2010年3月至2012年3月收治的50例低位晚期直肠癌患者使用新辅助放化疗并手术治疗,放化疗期间患者出现不同程度的毒副反应,如：消化系统毒性、骨髓抑制、手足综合征、放射性直肠炎、肛周放射性皮炎等,给予相应的心理、饮食及药物护理。结果本组50例患者,经积极护理干预,全部完成新辅助放化疗治疗,其中39例（78%）患者出现不同程度的毒副反应,多为I和Ⅱ级反应,其中14例（28%）出现消化系统毒性反应;12例（24%）出现中性粒细胞减少;4例（8%）出现手足综合征;11例（22%）出现放射性直肠炎;15例（30%）出现肛周放射性皮炎,所有患者均无Ⅲ、Ⅳ级毒副反应发生,无毒性死亡病例。结论新辅助放化疗治疗低位晚期直肠癌配合有效的护理措施,能有效减轻放化疗的不良反应,提高患者生存质量,有利于患者的预后和康复。

Clinical observation and nursing for lower advanced rectal cancer on neoadjuvant chemoradiotherapy

Objective To investigate the adverse reaction and nursing measure for lower advanced rectal cancer on neoadjuvant chemoradiotherapy. Methods 50 cases of patients with low rectal cancer using advanced neoadjuvant therapy and operation therapy from mar 2008 to mar 2010, toxicity of different degree was appeared during neoadjuvant chemoradiotherapy, such as： digestive system toxicity, bone marrow suppression, hand-foot syndrome, radiation proctitis,anal radioactive dermatitis and so on, give corresponding psychological, diet and medication nursing. Results All the patients completed neoadjuvant chemoradiation therapy under the active nursing intervention, toxicity of different degree was appeared in 39 patients, 14 cases had digestive system toxicity, 12 cases had neutropenia, 4 cases had hand-foot syndrome,11 cases had radiation proctitis, 15 cases had anal radioactive dermatitis. Conclusion Neoadjuvant chemotherapy with effective nursing measures in treatment of lower advanced rectal cancer can effectively reduce the adverse reaction, improve the quality of life, neoadjuvant chemotherapy is conducive to the prognosis and rehabilitation of patients.