头颈部肿瘤患者在放射治疗中发生幽闭恐惧症的综合干预

目的 探讨头颈部肿瘤接受调强放射治疗时合并幽闭恐惧症患者的心理状态及其有效干预措施。 方法 2015年1月-2017年3月某三甲医院肿瘤科收治的718例头颈部肿瘤行调强放射治疗患者中22例出现不同程度的幽闭恐惧症。根据其临床症状及体征,分析其心理状态,并进行心理疏导,安排经验丰富且固定的治疗师,优化放射治疗计划,给予适宜的面膜固定以及口服镇静剂等方法进行干预。结果 22例患者首次CT定位均未成功,进行综合干预后16例(72.7%)患者第2次定位成功,5例(22.7%)患者第3次定位成功, 1例(4.6%)患者放弃定位。干预后患者的呼吸频率、脉搏、血压较干预前有明显改善。结论 有效的干预措施可减轻幽闭恐惧症患者的症状,提高CT定位与治疗摆位的成功率,保证患者顺利完成整个疗程的放射治疗。

Comprehensive prevention from claustrophobia for head and neck cancer patients receiving radiation therapy

Objective To explore the psychological state and effective intervention measures for patients with head and neck cancer combined with claustrophobia. Methods From January 2015 to March 2017, among 718 head and neck cancer patients undergoning intensity-modulated radiotherapy, 22 patients were found suffering from claustrophobia. According to their clinical symptoms and signs, their psychological state was analyzed and psychological counseling was given by experienced therapists, in addition to optimized radiotherapy plan, the appropriate mask fixation and medication. Results Among the 22 patients unsuccessfully positioned for the first time, after the intervention, 16 patients (72.7%) succeeded during the second CT positioning, while 5 patients (22.7%) succeeded during the third time, with another one giving up. After the intervention, significant improvement was observed in the respiratory rate, pulse and blood pressure. Conclusion Effective intervention can reduce the symptoms of patients with claustrophobia, improve the success rate of CT simulation and placement, so as to guarentee the whole treatment.