心理护理对喉癌患者术后生存质量的影响

目的了解喉癌患者术后恢复期的生活质量,探讨心理干预对喉癌患者生存质量的影响。方法采用欧洲癌症研究与治疗组织研制的生活质量核心量表（EORTC QLQ-C30）,对46例喉癌患者进行生活质量测量和评价。结果心理干预前后患者生存质量差异有统计学意义。结论喉癌患者术前、术后存在不良心理状态,实施系统的心理干预能提高喉癌术后患者的生存质量     

分析激励式护理对喉癌术后患者的护理效果情况

目的 本研究旨在分析激励式护理同常规护理对喉癌术后患者护理效果情况。方法 选取2020年8月至2021年5月间于我院进行住院治疗且需行手术治疗的喉癌患者共计98例,将入组患者按照随机数字表法平均分成两组,每组各49例,将应用激励式护理方法的患者记为观察组,应用常规护理方法的患者记为对照组。分别记录两组患者的治疗依从性情况、自我护理能力评分及生活质量评分情况。结果 观察组患者治疗依从性明显高于对照组,差异具有统计学意义(P<0.05);两组护理干预前自我护理能力评分及生活质量评分间无差异(P>0.05),护理干预后两组自我护理能力评分及生活质量评分均提高,但观察组各项评分均明显高于对照组,差异具有统计学意义(P<0.05)。结论 激励式护理对喉癌患者的治疗依从性提升较大,同时增强了患者的自我护理能力,从而提高了其生活质量。     

食管贲门癌术后并发胃食管反流的护理配合效果评价

目的 探讨食管贲门癌术后并发胃食管反流患者开展系统性护理干预的临床疗效。方法 遴选8 0例食管贲门癌术后并发胃食管反流患者（2 0 1 9年1月-2 0 2 1年1 2月），在“系统抽样法”原则下分2组—对照组与观察组，前者实施常规护理，后者开展系统性护理干预，各纳入病例40例；评估两组患者心理状态、症状积分、生活质量展开组间对比。结果 较对照组研究结果，观察组干预后观察组焦虑抑郁（SAS、SDS）评分更低，同时上腹部灼痛、反酸、胸骨后灼痛症状积分明显低，且术后生活质量（QLQ-C30）各个维度评分均更高（P<0.05）。结论 开展系统性护理干预对食管贲门癌术后并发胃食管反流患者，不仅可以改善焦虑、抑郁，有效缓解反流症状，同时促进生活质量大幅度提高，实现良好预后结果。     

分析激励式护理对喉癌术后患者的护理效果情况

目的 研究激励式护理对喉癌术后患者护理效果造成的影响。方法 选取我院2020年9月1日～2022年9月收治的60例喉癌患者作为研究对象,以奇偶数交替方式分组,对照组纳入30例患者,自愿接受常规护理方案,其余30例为观察组患者,在常规护理基础上,增加术后激励式护理,比较两组护理依从性、满意度、疼痛感、睡眠质量、自我效能感、负性心理。结果 观察组完全依从、部分依从例数增加,护理依从性与对照组比较后,差异显著(P<0.05);观察组护理满意度高于对照组(P<0.05);观察组VAS评分、PSQI评分均低于对照组,患者疼痛感减轻,睡眠质量良好,组间差异明显(P<0.05);观察组GSES自我效能感评分提高、SAS、SDS量表分值低于对照组,患者焦虑、抑郁症状改善,组间差异有统计学意义(P<0.05)。结论 在喉癌术后患者护理中,采取激励式护理措施产生的效果良好,能够提高护理依从性与满意度,有利于减轻患者疼痛感,并改善睡眠质量。激励式护理也能够缓解焦虑、抑郁负性心理,使得患者自我效能感提升。     

循证护理模式在喉癌手术室护理中的应用分析

目的 分析循证护理模式在喉癌手术室护理中的应用效果。方法 选取2019年1月-2020年12月期间在我院接受手术治疗的喉癌患者92例进行分组研究,分组办法为数字随机法,其中采取常规手术室护理的为对照组(n=46),采取手术室循证护理的为研究组(n=46),比较两组患者护理效果。结果(1)研究组患者术手用时、术后住院天数、术后吞咽功能恢复时间均明显比对照组用时要短、术中出血量、术后呼吸道感染发生率以及术后12h视觉模拟评分(VAS)均明显比对照组要低(P<0.05);(2)护理后研究组患者SAS以及SDS评分结果均明显低于对照组(P<0.05)。结论 早循证护理模式应用于喉部手术室护理效果较好,利于促进患者康复,值得推广。     

喉癌患者术后抑郁和焦虑的发病因素分析及其对喉癌患者预后和生活质量的影响

目的　探讨喉癌患者术后抑郁、焦虑发病的因素及其对喉癌患者预后和生活质量的影响。方法　对2010年1月1日～2012年10月31日在我院住院的84例喉癌患者于术后1个月进行问卷调查，包括一般资料问卷、Zung焦虑自评量表和抑郁自评量表，而生活质量EORTC QLQ-C30问卷分别在术后1个月、3年和5年进行问卷调查。应用SPSS 19.0统计学软件完成数据统计及分析。结果　78例喉癌患者完成随访，3年生存率为71.79%（56/78），5年生存率为57.69%（45/78）。术后1个月有52例（66.67%）患者抑郁阳性，43例（55.13%）患者焦虑阳性。低文化水平、低收入、长期吸烟、喉全切除及术后放疗的喉癌患者抑郁的发病率高，而经常 吸烟、喉全切除、发音功能及吞咽功能差的喉癌术后患者，焦虑的发病率高。抑郁组与对照组相比，术后5年的生存率差异有统计学意义，而术后3年生存率的差异无统计学意义；焦虑组和对照组相比，术后3年、5年生存率差异均无统计学意义。术后抑郁对患者的整体健康状况影响较大，但焦虑对生活质量的影响范围更广。抑郁和焦虑对患者术后失眠均有较大影响，且贯穿整个观察时间。结论　多重因素导致喉癌患者术后抑郁和焦虑。仅抑郁对患者术后5年生存率有影响；抑郁和焦虑均对患者术后生活质量造成影响，但影响方面不同。     

护理干预在颈部淋巴瘤患者合并化脓性感染中的有效性分析

目的 研究颈部淋巴瘤伴化脓性感染患者行综合护理干预的效果。方法 数据取自本院2019年1月-2022年1月收治80例颈部淋巴瘤伴化脓性感染患者，“随机取样法”分参照组(传统护理，n=40)、科研组(综合护理干预，n=40),2组疗效比较。结果 干预前比较2组生活质量、临床指标无差异，P>0.05；干预后与参照组比较，科研组QLQ-C30评分、CD-RICS评分更高；SAS、SDS评分更低；科研组满意率(95.00%)高于参照组(80.00%)，χ²=4.114,p=0.043,P<0.05(具有统计学意义)。结论 综合护理干预可改善颈部淋巴瘤伴化脓性感染患者生活质量、减轻心理应激性，提高满意度、值得推崇。     

双向转诊医疗模式下对喉癌术后康复期戴管下转患者联合延续护理应用的效果

目的分析双向转诊医疗模式下对喉癌术后戴管下转患者联合延续护理应用的效果。方法将2015年1月~2016年12月喉癌住院行部分喉切除术后4~6天,病情稳定,戴气管套管转诊下级医院康复的患者40例,随机分为研究组和对照组各20例。对照组常规出院宣教后按一般转诊流程转诊,研究组常规出院宣教后转诊时联合应用延续护理,对两组患者的住院时间、住院费用、相关知识知晓情况及满意度进行统计分析。结果喉癌术后戴管下转患者研究组平均住院时间短于对照组(P0.05),住院费用低于对照组(P0.05),健康教育测试成绩显著高于对照组(P0.05),临床护理工作满意度高于对照组(P0.05)。结论喉癌术后康复期戴管下转患者联合延续护理的应用效果显著,值得推广。     

基于ERAS理念的护理干预对喉癌手术患者术后康复效果的影响

目的 探讨基于加速康复外科(ERAS)理念的护理干预在喉癌手术患者中的运用效果。方法 选取2019年10月-2021年10月我院收治的68例喉癌手术患者为研究对象,按随机数字表法分为两组各34例。对照组给予常规护理,观察组采用基于ERAS理念的护理干预,持续观察至患者出院。对比两组术后疼痛、术后恢复情况、并发症发生率及护理满意度。结果 术后6h两组视觉模拟评分量表(VAS)评分比较,差异无统计学意义(P>0.05);术后72h观察组VAS评分低于对照组,(P<0.05);观察组术后经口进食时间、下床活动时间、住院时间均短于对照组,(P<0.05);观察组并发症发生率5.88%低于对照组的23.53%,(P<0.05);观察组护理满意度100%,高于对照组的82.35%,(P<0.05)。结论 基于ERAS理念的护理干预用于喉癌手术患者中效果确切,能够减轻术后疼痛,减少并发症的发生,促进术后康复,提高患者护理满意度。     

伤口团队介入喉癌术后咽瘘护理的效果评价

目的总结伤口团队对喉癌术后发生咽瘘患者的护理要点。方法选取上海市某三级甲等综合性医院耳鼻咽喉科病房2018年1～6月喉癌术后符合纳入标准的45例病人作为对照组,实施传统的咽瘘换药方法。选取同科室2018年7～12月喉癌术后符合纳入标准的45例病人作为实验组,通过伤口团队评估伤口程度,制定换药方法,对病人实施相应的换药方法。结果实验组病人的伤口的清洁程度、细菌培养结果、愈合时间长短及患者舒适度均优于对照组(P0.01)。结论伤口团队介入喉癌术后咽瘘护理,可以促进咽瘘的修复,提高咽瘘患者的护理质量,并改善病人的舒适度。     

以家庭为中心的护理干预对喉癌术后化疗患者近远期疗效的影响研究

目的分析喉癌术后化疗患者采取以家庭为中心的护理干预对近远期疗效的影响。方法将我院2017年10月-2020年10月期间接受治疗的60例喉癌术后化疗患者作为研究对象,分为常规组与观察组,常规组患者接受常规护理干预,观察组患者进行以家庭为中心的护理干预,比较两组患者近期疗效、远期疗效、并发症发生率、护理满意度。结果观察组患者近期疗效、生活质量评分、观察组患者满意度均高于常规组患者,P<0.05。结论以家庭为中心的护理干预模式效果显著,可以考虑积极推广。     

Quality of life for patients following total laryngectomy vs chemoradiation for laryngeal preservation

BACKGROUND: The incorporation of chemotherapy and radiation, either sequentially or concurrently, has been increasingly used for organ preservation in patients with advanced laryngeal cancer. Traditional outcome measures of clinical response such as locoregional control and survival have been similar for patients treated with chemoradiotherapy and those treated with total laryngectomy (TL). The impact of concurrent chemoradiotherapy for laryngeal preservation on the overall quality of life (QOL) of patients has not been clearly evaluated, particularly in direct comparison with TL. OBJECTIVE: To compare the QOL of patients treated with concurrent chemoradiotherapy with those treated with TL. DESIGN: Nonrandomized, retrospective, cross-sectional study. SETTING: Academic tertiary care referral center. METHODS: The study included 42 patients with advanced stage III or IV cancer of the larynx, who were treated with either concurrent chemoradiotherapy or TL with postoperative radiation therapy. Patients had to be without evidence of recurrence and to have completed therapy at least 3 months prior to inclusion in the study. Quality of life was measured using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30) in tandem with the head and neck module (EORTC QLQ-H&N35). RESULTS: On the core questionnaire (QLQ-C30), there were no statistically significant differences in the overall QOL score between the 2 groups. Functional subscale analysis revealed a trend for patients in the surgery and radiotherapy group to experience greater difficulties with social functioning (P =.18) relative to the chemoradiation group. On the QLQ-H&N35, surgery patients reported significantly greater difficulties with sensory disturbances (smell and taste, P =.001), use of painkillers (P =.049), and coughing (P =.004). On the other hand, chemoradiation patients reported significantly greater problems with dry mouth (P =.02). CONCLUSIONS: Both chemoradiation and TL affect, albeit differently, the QOL of patients treated for advanced cancer of the larynx. Although these differences can be detected by functional and subscale analysis, the overall QOL scores of both groups seem similar.     

Quality of life and voice in patients with laryngeal carcinoma: A posttreatment comparison of laryngectomy (salvage surgery) versus radiotherapy

Objectives: This study was designed to compare the voice and the quality of life (QOL) of laryngeal cancer patients receiving treatment with radical radiotherapy with or without laryngectomy as salvage surgery. We also compared the patients' own perceptual ratings of their voice to the perceptual ratings of a group of listeners. Study Design: Two groups of laryngeal cancer patients were studied. Methods: Fourteen irradiated laryngeal speakers with preserved larynx were matched with 14 salvage surgery laryngectomized patients speaking with tracheoesophageal prosthesis (TEP). To measure patients' QOL, we used the European Organisation for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30), the EORTC Head and Neck module (EORTC QLQ-H&N35), the Hospital Anxiety and Depression scale (HAD) and a study-specific questionnaire. For the perceptual speech evaluation we used visual analog scales. Results: The perceptual ratings of speech intelligibility, voice quality, and speech acceptability showed a significant difference between the treatment groups. Both the patients who received treatment with radiotherapy and the listeners rated the irradiated laryngeal voices higher than the tracheoesophageal speech. The laryngectomized patients scored significantly better than the patients treated with radical radiotherapy on the question about hoarseness. No other significant difference was found for the QOL functions and symptoms. Conclusion: When patients treated with radiotherapy were compared with patients treated with laryngectomy as salvage surgery, QOL was similar, only small differences being found in the perceptual speech evaluation. Laryngoscope, 108:1566–1573, 1998     

Quality of life and voice intelligibility in laryngeal cancer patients--relevance of the "satisfaction paradox"

BACKGROUND: Aim of this study was to compare postoperative quality of life and voice intelligibility of laryngeal cancer patients. PATIENTS AND METHODS: Two studies assessed the quality of life (by EORTC QLQ-C30 and EORTC QLQ-H&N35) and the voice intelligibility (by PLTT and FPAL) of 218 laryngectomized and 151 partially resected patients. The data of 86 patients was analysed on the basis of matched pairs (matching criteria: sex and tumour stage). RESULTS: The smelling and tasting of the laryngectomized patients were more affected. Other domains of quality of life did not differ significantly between the groups. The subjective assessment of voice intelligibility led to worse results among the patients with partial laryngectomy, although the objective test proved the contrary. CONCLUSIONS: Subjective and objective assessment of quality of life can differ, which led to paradox results in this study, especially for voice intelligibility. This might be due to the fact that partially resected patients have higher expectations of their operation.     

Quality of life after different treatment modalities for carcinoma of the oropharynx

OBJECTIVES: To assess the long-term posttreatment quality of life of patients with carcinoma of the oropharynx treated with different treatment modalities. STUDY DESIGN: Retrospective chart review and patient response to EORTC quality of life core questionnaire QLQ-C30 and EORTC quality of life core head and neck cancer module QLQ-H&N35 questionnaires. METHODS: Two hundred and seventeen patients with carcinoma of the oropharynx were treated with curative intent between 1990 and 1998. In January 2001, a total of 111 disease-free survivors were identified and included in this study. The questionnaires were completed by 99 patients (89% completion rate). RESULTS: Of 99 patients, 31 patients were treated with surgery alone, 19 with radiation therapy alone and 49 with surgery followed by postoperative irradiation. Median follow-up for the entire study group was 71 months. Physical, role, emotional, cognitive and social functioning reflected in the functional scale scores of the global EORTC QLQ-C30 were generally good and showed no significant differences for the different treatment modalities. Comparison of the head and neck specific EORTC QLQ-H&N35 scores revealed significantly less troubles with swallowing (P = 0.006), social eating (P = 0.007) and social contact (P = 0.008), dry mouth (P < 0.0001), sticky saliva (P = 0.0001) and mouth opening (P = 0.001) in non-irradiated patients versus those treated with any either primary or postoperative radiation therapy. Patients undergoing surgery (with and without postoperative irradiation) had less pain (P = 0.04), less problems with social eating (P = 0.009) and less restricted mouth opening (P = 0.03) than the nonsurgically treated patients. CONCLUSIONS: Quality of life after curative treatment of oropharyngeal carcinoma is generally good. Differences regarding quality of life between the different treatment modalities manifest themselves in the head and neck specific EORTC QLQ-H&N35 module, not in the global core questionnaire EORTC QLQ-C30.     

Quality of life after treatment for early laryngeal carcinoma

Radiotherapy and surgery for early laryngeal cancer achieve comparably good results in patient survival, and the choice of treatment between them is being influenced increasingly by the expected voice quality and quality of life (QoL). The superiority of vocal function after radiotherapy has been shown in previous objective voice assessment studies. This study compared the QoL of long-term survivors after endoscopic laser surgery or radiotherapy for early laryngeal carcinoma. QoL was evaluated with two validated questionnaires: the global EORTC QLQ-C30 and the head- and neck-specific EORTC QLQ-H & N35. A total of 62 patients were included. Among 56 patients completing the questionnaires (90% completion rate) 40 were treated by endoscopic CO₂ laser surgery and 16 with radiation therapy. All 56 patients showed a good global QoL with no significant difference between the two treatment modalities. The head- and neck-specific evaluation revealed significantly better scores for surgically treated patients in questions about swallowing of solid food, xerostomia, and tooth problems, but no difference in questions about voice quality. Both treatment modalities achieve good QoL after treatment of early laryngeal tumors. Irradiated patients mainly complain about xerostomia related problems. In contrast to objective measurements long-term survivors after surgery do not rate their voice poorer than irradiated patients. The EORTC questionnaires are validated and useful tools in assessing QoL and should further be used in prospective trials. Received: 7 September 2000 / Accepted: 6 November 2000     

Quality of life correlates after surgery for laryngeal carcinoma

OBJECTIVES: To assess the correlation of operation mode, postoperative radiotherapy, and disease stage factors with the health-related quality of life (HRQL) measures after surgery for laryngeal carcinoma. STUDY DESIGN: Reanalysis of data of two multi-institutional cross-sectional studies. PATIENTS AND METHODS: We interviewed 218 laryngectomees and 153 partial laryngectomy patients in and near Leipzig, Germany, in two cross-sectional studies, using the general and the head- and neck-specific quality of life questionnaires of the European Organization for the Research and Treatment of Cancer (EORTC QLQ-C30 and EORTC QLQ-H&N35). Multifactorial univariate and multivariate models were calculated, with laryngectomy vs. partial laryngectomy, radiotherapy (irradiated or not), and disease stage (International Union Against Cancer [UICC] stages I/II vs. III/IV) as influencing factors and the HRQL scales and items as dependent variables. Analyses were adjusted for the patient's age and the time elapsed since the operation. RESULTS: Laryngectomees were more affected in their sense of smell (P < or = .000). Among irradiated patients, functioning levels and many symptom scales showed worse results (P < or = .05). Both operation mode and postoperative radiotherapy were independently associated with head- and neck-specific HRQL in multivariate analysis. Differences between disease stage groups, however, were not significant. Patient's age was an influencing factor on HRQL, but time since operation was not. CONCLUSIONS:: Postoperative radiotherapy seems to have the greatest impact on patients' HRQL independent of other clinical factors following surgery for laryngeal carcinoma. Aftercare of irradiated laryngeal carcinoma patients should focus more on the patient's quality of life.     

Significance of support groups for patients after total laryngectomy for laryngeal carcinoma

The aim of this study was to determine the relationship between the quality of life (QL) assessment and attachment to support group in patients after total laryngectomy. Material consisted of 60 patients with squamous cell carcinoma of the larynx, inclusive of 30 patients belonging to the supported group. The questionnaire of QL EORTC QLQ-C30, the EORTC head and neck cancer module QLQ-H&N35 and Hospital Anxiety and Depression Scale HAD were used. We found out that the somatic, performance and social dimension of QL of patients belonging to the supported group are higher than others patients.     

A Prospective Quality of Life Study of Patients With Laryngeal Carcinoma by Tumor Stage and Different Radiation Therapy Schedules

This study was designed to prospectively monitor the quality of life of laryngeal cancer patients, to compare the quality of life of patients with small tumors with that of patients with large tumors, and to test any quality of life difference in patients with small tumors treated with conventional versus hyperfractioned accelerated radiation therapy. Patients having had a laryngectomy within the study year were also analyzed separately. The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire (QLQ-C30), the EORTC Head and Neck Module (H&N-37), and the Hospital Anxiety and Depression (HAD) scale were administered six times during 1 year. These questionnaires were found to be suitable for measuring laryngeal cancer patients' quality of life longitudinally. The questionnaires were sensitive to differences in quality of life for small versus large tumors and showed that hyperfractioned accelerated radiation therapy was advantageous compared with conventional radiation therapy with respect to quality of life at the 1-year follow-up.     

39例环后癌的外科治疗及临床疗效分析

目的探讨环后癌的外科治疗方法及临床疗效。方法回顾性分析2010~2018年行外科治疗的39例环后癌患者,其中男38例,女1例;年龄39～70岁。根据2002年UICC分期规定：I期7例,II期7例,III期8例,IV期17例。行保留喉功能者25例,不保留喉功能者14例;在完整切除肿瘤后进行咽喉功能的修复重建。术前诱导化疗+手术+术后辅助放疗者15例,手术+术后辅助放疗者14例,术前诱导化疗+手术者8例,单纯手术者2例。结果术后出现咽瘘5例,下咽狭窄2例,分别予换药和食管镜下扩张后II期愈合。随访时间5～65个月,随访5年及以上者5例 ,健在1例;随访3年以上者18例,健在7例,其余未随访至3年,7例失访。经Log rank检验,是否保留喉功能组间、进行术前诱导化疗联合术后辅助放疗的患者与仅进行术后辅助放疗的患者组间、患者有无淋巴结转移组间、及I II期与III IV期组间生存率差异均无统计学意义（P＞0.05）。结论随着环后癌外科治疗的发展,在安全切除癌灶的基础上可酌情保留中晚期喉功能,结合外科综合治疗可一定程度提升患者生活质量。