冰帽与止血带对紫杉醇+奈达铂化疗的妇科恶性肿瘤病人脱发的延缓效果

[目的]利用冰帽与止血带,对妇科行紫杉醇+奈达铂(TP)化疗方案的恶性肿瘤病人进行头皮处理,进而筛选出临床上能够有效缓解病人脱发问题的方法。[方法]选择2016年1月—2017年7月妇科行紫杉醇+奈达铂化疗方案的90例恶性肿瘤病人入组,随机分配到对照组、冰帽组、冰帽+止血带组,每组30例病人,各组化疗方案及年龄差异无统计学意义。脱发量评价依据世界卫生组织(WHO)关于脱发的分级标准进行评价,将脱发量≤50. 0%视为有效缓解脱发。所有病人均完成了4周期化疗。[结果]完成4周期化疗的病人,冰帽组脱发量≤50. 0%的病人占36. 0%(9/25),冰帽+止血带组脱发量≤50%的病人占33. 3%(9/27),对照组病人脱发量全部50. 0%;与对照组比较,每周期化疗开始前冰帽组和冰帽+止血带组在缓解妇科化疗病人脱发的效果明显(P0. 001),冰帽组和冰帽+止血带组比较差异无统计学意义(P0. 05),说明冰帽和冰帽+止血带缓解脱发效果一致。[结论]佩戴冰帽以及冰帽+止血带均能有效缓解妇科恶性肿瘤紫杉醇+奈达铂方案化疗病人的脱发,且效果相同。另外单独使用冰帽从病人佩戴舒适感以及临床操作角度更优于冰帽+止血带组。     

应用冰帽预防妇科恶性肿瘤化疗导致的脱发

目的：观察冰帽预防妇科恶性肿瘤化疗导致脱发的临床价值。方法：选取2020年9月至2022年1月在九江市妇幼保健院接受化疗的早中期妇科恶性肿瘤患者60例,随机分为实验组与对照组各30例,两组均选用紫杉醇+铂类化疗方案化疗,化疗期间实验组佩戴统一规格的医用冰帽,对照组不佩戴医用冰帽,化疗完成后,比较两组患者脱发情况以及治疗前后情绪、生活质量改善情况。结果：化疗完成后,实验组脱发等级、脱发总缓解效果优于对照组（P<0.05）;治疗后,实验组焦虑评分、抑郁评分以及南丁格尔症状评估量表（N-SAS）评分均低于对照组（P<0.05）。结论：应用冰帽预防妇科恶性肿瘤化疗导致的脱发效果较好,可作为临床预防和减轻脱发的有效手段。     

医用冰帽在女性乳腺癌患者脱发预防中的效果观察

目的观察冰帽对预防女性乳腺癌患者脱发的效果。方法选择2019年1月—2020年1月宁夏某三甲医院肿瘤内科拟行首次化疗的早期青中年女性乳腺癌患者74例,随机分为对照组和干预组各37例。对照组化疗期间不对头皮做任何冷却处理,干预组采用医用冰帽进行头皮持续降温处理。四个化疗周期结束后,比较两组患者的脱发程度及患者满意度。结果两组患者化疗4周期结束后,干预组37例中,无明显脱发2例,Ⅰ级脱发14例,Ⅱ级脱发14例,Ⅲ级以上脱发7例;对照组37例中,无明显脱发0例,Ⅰ级脱发0例,Ⅱ级脱发0例,Ⅲ级以上脱发37例。两组患者脱发程度比较,差异有统计学意义(P0.05)。干预组37例中,患者对化疗所致的脱发28例满意,9例不满意;对照组37例中,对化疗所致的脱发有10例满意,27例不满意,两组患者满意度比较差异有统计学意义(P0.05)。结论应用医用冰帽预防女性乳腺癌患者化疗所致脱发,可明显减缓患者脱发程度,提高患者满意度,有一定推广应用价值。     

综合护理干预对乳腺癌患者化疗依从性的影响

目的探讨综合护理干预对乳腺癌患者化疗依从性的影响。方法将60例乳腺癌患者随机分为干预组和对照组各30例，两组均接受乳腺癌常规联合化疗和常规护理，干预组在此基础上给予相应综合护理干预，观察4w。于综合护理干预4W末对两组化疗依从性进行对比分析。结果综合护理干预4w末，干预组化疗依从性显著优于对照组（U=3．319，P〈0．01）。结论综合护理干预可显著提高乳腺癌患者化疗的依从性。     

自制中药洗剂防治乳腺癌化疗脱发30例效果观察

目的:探讨自制中药洗剂防治乳腺癌化疗脱发的效果.方法:将60例乳腺癌患者随机分为干预组和对照各30例,两组均接受统一化疗方案,均给予化疗常规护理,且干预组于化疗前2d开始在发根涂抹自制中药洗剂,2次/d,连用10d.结果:两组在化疗致脱发毒性反应6个化疗周期脱发状况比较,均有显著性差异(P＜0.01).结论:干预组通过涂抹自制中药洗剂等措施可改善头皮毛囊的血液营养状态,减轻化疗致脱发的毒性反应,为进一步探讨中医药防治化疗毒性反应提供了一定的依据.     

乳腺癌患者化疗期间味觉改变趋势及影响因素分析

目的描述乳腺癌患者化疗相关性味觉改变的变化规律,分析其影响因素,为制定针对性干预措施提供参考。 方法采用前瞻性纵向研究设计,在北京市某三甲医院乳腺中心招募90例乳腺癌化疗患者,分别于化疗前、第2次化疗前、末次化疗前对患者进行测评,采用中文版化疗相关味觉改变量表测评患者的味觉改变情况。采用广义估计方程分析各测评时间点化疗相关味觉改变情况及其影响因素。 结果最终共89例患者纳入最终分析,平均年龄为（53.5±9.4）岁,26例（29.21%）患者接受新辅助化疗,63例（70.79%）患者接受辅助化疗。乳腺癌患者首次化疗前、第2次化疗前、末次化疗前的化疗相关味觉改变总分分别为（18.69±1.59）、（22.53±4.24）、（25.14±5.68）分;广义估计方程分析发现,化疗相关味觉改变总分、整体性味觉均分、基本味觉均分随着化疗进行逐渐加重（P＜0.01）;味觉异常均分、不适症状均分在首次化疗后即明显改变（P＜0.01）,化疗期间不再明显加重（P＞0.05）。化疗相关味觉改变总分与年龄、化疗方案密切相关。 结论乳腺癌患者在化疗期间经受着逐渐加重的味觉变化,年龄、化疗方案是化疗相关味觉改变的影响因素。提示应重视味觉改变的健康宣教和干预,以减轻乳腺癌化疗患者的味觉改变情况。     

冰帽防治化疗药物引起脱发的临床观察

化疗是癌症病人的重要治疗方法之一。大剂量联合化疗时，常可引起患者的严重脱发。为预防因化疗药物所致的脱发，我们对50例患者采用冰幅降温的方法，防治大量脱发，疗效较好，观介绍如下。1临床资料我科自1995年6月～1997年10月共收治癌症患者IOO例。均属首次化疗。其中男34例，女66例。年龄17～56岁，胃癌14例、肝癌18例、直肠癌6例、卵巢癌6例，乳腺癌32例、肺癌16例、白血病8例。将100例随机分为两组，SO例使用冰帽、50例不使用冰帽为对照组。临床用药：环磷酸胺1000mp／次、表阿霉素50Tug／次、阿霉素stw／次、卡铂500mg／次、顺铂8…     

自我效能干预对乳腺癌术后化疗癌因性疲乏的影响

目的探讨自我效能干预对乳腺癌患者术后化疗癌因性疲乏的影响。方法将52例乳腺癌术后化疗患者随机分为实验组和对照组各26例。对照组采用一般护理常规实施护理,实验组在此基础上增加癌因性疲乏的自我效能干预。利用修订的Piper疲乏量表（RPFS）评价2组患者的CRF程度。结果干预前2组疲乏值比较差异无统计学意义,干预后实验组疲乏值低于对照组（P〈0．05）。结论自我效能干预可有效缓解乳腺癌术后化疗患者的CRF,提高患者的生活质量。     

循经冥想联合积极心理暗示对乳腺癌化疗患者心境及疲乏症状群的影响

目的 观察循经冥想联合积极心理暗示对乳腺癌化疗患者心境及疲乏症状群的影响。方法 于2021年1－6月从江苏省人民医院乳腺科收治的乳腺癌术后拟化疗患者中选取80例为研究对象,按照在线随机数字生成器生成的随机数字表分为观察组和对照组。对照组实施化疗常规护理及分级心理干预,观察组在对照组的基础上增加循经冥想联合积极心理暗示的护理干预,分别在两组干预前、第2次化疗（干预3周）、第3次化疗（干预6周）及第4次化疗（干预9周）时,采用简式简明心境问卷（POMS-SF）、匹兹堡睡眠质量指数（PSQI）及癌症疲乏量表（CFS）评价干预效果。结果 干预前,两组均无统计学差异（P>0.05）。干预后,观察组的心境（POMS-SF）及疲乏（PSQI、CFS）评分均优于对照组,且评分随干预时间的变化而变化,干预时间越长效果越好,差异均有统计学意义（P<0.05）。结论 循经冥想联合积极心理暗示能够改善乳腺癌化疗患者负性心境及疲乏症状群的困扰,促进患者身心康复。     

分期匹配心理干预在乳腺癌术后化疗患者中的应用

目的观察分期匹配心理干预在乳腺癌术后化疗患者中的应用效果。方法选择2015年10～12月于该院行化疗的92例乳腺癌术后患者作为研究对象,随机分为对照组与试验组各46例,对照组施以常规心理干预,试验组施以分期匹配心理干预,比较两组干预后各相关指标的差异性。结果试验组乳腺癌化疗病例干预后心理弹性各维度及总评分、化疗反应缓解度评分、生活质量评分均显著高于对照组同类化疗病例（P〈0．05）。结论将分期匹配心理干预法应用于乳腺癌术后化疗患者之中,对于提高该类化疗病例心理弹性水平、缓解化疗不良反应和提高生活质量均具备积极效应。     

Scalp cooling in the prevention of alopecia in patients receiving depilating chemotherapy

To assess any difference in the incidence of alopecia during treatment and of skull metastases during follow-up among breast cancer patients undergoing scalp cooling during chemotherapy and those treated at ambient temperatures. A series of 35 breast cancer patients receiving adjuvant chemotherapy were consecutively assigned either to a scalp cooling regimen (19 patients) or to an ambient temperature regimen (16 patients). Hypothermia was administered with electrically cooled caps (SCS 11: Amit Technology, Jerusalem) for 30 min before, during, and for 1 h after treatment. A significant difference (P=0.014) was detected in the incidence of alopoecia: 48% (9 patients) of those who had undergone cooling suffered alopoecia, while 81% (13 patients) of the group who had not undergone cooling lost scalp hair. Patient comfort levels were high. Follow-up (median time 14 months) has disclosed no scalp metastases. The implementation of routine scalp hypothermia as part of adjuvant chemotherapy treatment, especially in cancers without tendencies to bone metastases, should be seriously considered.     

Efficacy and tolerance of a scalp-cooling system for prevention of hair loss and the experience of breast cancer patients treated by adjuvant chemotherapy

The applicability and efficacy of a scalp cooling system were studied in 105 breast cancer patients receiving four cycles of adjuvant chemotherapy with mitoxantrone + cyclophosphamide (NC chemotherapy). Women accepting the scalp-cooling system were compared for alopecia both against those who refused and against a "reference" group of 109 patients similarly treated but without being offered a scalp-cooling system. Hair loss in the 105 study patients was evaluated by nurses using World Health Organization (WHO) criteria at each cycle of chemotherapy. Concomitantly, tolerance and side-effects of the helmet were also recorded in 48 accepting patients. Similarly to reference group patients, a subsample of 27 accepting patients self-assessed hair loss using a specific questionnaire measuring its frequency and severity and the distress associated with this symptom. Nurses' ratings ( n = 105) indicated that hair loss frequency was constantly lower, at each cycle of chemotherapy, in study patients with scalp-cooling system ( n = 77) than in those without ( n = 28). Differences between the two groups were statistically significant at cycles 1 and 3 ( P < 0.05). When compared with those reported by reference group patients ( n = 109), study patients' self-measures of alopecia frequency ( n = 27) provided even more marked results than those achieved by nurses (cycles 1-3: P < 0.01; cycle 4: P < 0.05). Tolerance was generally good and no scalp metastasis was observed among the 77 accepting patients followed up. This study demonstrates that scalp cooling was an effective method of protection against hair loss caused by NC chemotherapy. Its routine use as part of adjuvant chemotherapy, especially in cancers with low prevalences of scalp metastasis, should be seriously considered.     

Scalp hypothermia to prevent chemotherapy-induced alopecia is effective and safe: A pilot study of a new digitized scalp-cooling system used in 74 patients

GOALS: The aim of this study was to examine the efficacy and safety of a new digitized, controlled, scalp-cooling system to prevent chemotherapy-induced alopecia. METHOD: Seventy-four female cancer patients who received 13 varying chemotherapy regimens were included in a nonrandomized pilot study. The Digni 2-3 with Dignicap system consists of a refrigerator unit and a control unit integrated into a mobile cabinet and connected to a tight-fitting cooling cap. This system maintains a constant scalp temperature of +5 degrees C for many hours. In this study, 60 patients were treated for ovarian cancer with either taxane or epirubicin combination chemotherapy. Eight patients with Hodgkin's lymphoma, three with breast cancer, two with endometrial cancer, and one with sarcoma were also included. Photo documentation and patient assessment of hair loss and discomfort were performed. RESULTS: In anthracycline-treated patients, total prevention of hair loss was observed, whereas hair loss in paclitaxel/docetaxel-treated patients was minimal to none. The combination of anthracycline and taxane resulted in more hair loss, but only three of six patients used a wig. Scalp cooling was generally very well tolerated; only two of 74 patients discontinued use of the cold cap due to discomfort. No scalp metastases occurred over a median follow-up period of 15 months. CONCLUSIONS: The digitized, controlled, scalp-cooling system represents an effective and safe device that should be clinically evaluated in a randomized trial and in studies using other chemotherapy regimens to determine optimal temperatures and durations of cooling for maximal efficacy.     

Chemotherapy-induced alopecia: advice and support for hair loss

This article provides insight into the growth cycle of a hair follicle and the potential impact chemotherapy agents can have on this process, which often results in hair loss (alopecia). It explores the psychological consequences of chemotherapy-induced alopecia for an individual as a result of the perceptions of others as well as an individual's perception of his or her self-image. Despite the development of various forms of scalp cooling, chemotherapy-induced alopecia remains a major side effect for patients receiving chemotherapy; however, there have been improvements in wig provision and changing public opinion relating to baldness. Although chemotherapy-induced alopecia affects both males and females and all age groups, this article focuses on the potential impact for patients receiving chemotherapy as a form of treatment for breast cancer. As professionals we need to understand the social significance of hair in relation to a person's outward presentation and social interactions, along with the possible psychological implications of a person losing his or her bodily hair, and not just the head hair. We must aim to minimize the distress alopecia can cause by: ensuring we provide patients with up-to-date verbal and written information to enable them to prepare for losing their hair; helping them to preserve their self-image and minimize the psychological consequences of hair loss while receiving chemotherapy; and preparing them for their hair re-growth following completion of chemotherapy.     

Impact of scalp cooling on chemotherapy-induced alopecia,wig use and hair growth of patients with cancer

IntroductionCytotoxic therapy for patients with cancer frequently induces reversible, but long-lasting alopecia which might be prevented by scalp cooling. This study evaluates the effectiveness of scalp cooling with respect to the severity of chemotherapy-induced alopecia (CIA) and the purchase and use of wigs and head covers.Materials and methodsIn this observational study, scalp-cooled patients (n = 160) were compared with non scalp-cooled patients (n = 86) with several types of cancer. Patients were enrolled in 15, mostly general hospitals prior to taxane and/or anthracycline-based chemotherapy. Patients completed four questionnaires between the start and one year after the last chemotherapy.ResultsSeverity of CIA, and purchasing and actually wearing wigs and head covers were significantly lower among scalp-cooled than non scalp-cooled patients. Overall, scalp cooling reduced the use of wigs and head covers by 40%. Among 84 scalp-cooled patients who purchased a wig (53%), only 52 patients actually wore it (62%), and they just wore it intensively (86% daily) for less than six months (80%). Especially young patients camouflaged CIA with a head cover instead of a wig.DiscussionThe relatively long duration of CIA, the wish of many patients to camouflage or rather prevent it and the 40% reduction for head covering by scalp cooling, makes it a worthwhile supportive intervention. However, (cost-) effectiveness can be improved. Many scalp-cooled patients purchased a wig unnecessarily.     

化妆美容在乳腺癌化疗患者中的应用效果

目的:分析化妆美容对乳腺癌化疗患者的干预效果。方法:采用便利抽样法,选取2017年9月至2018年2月天津市某医院80名女性乳腺癌患者,按入院时间分为干预组和对照组。对照组接受常规照护,干预组在常规照护的基础上,给予化妆美容。比较两组患者的化疗脱发困扰、医学应对方式及生活质量差异。结果:实施化妆美容后干预组在面对应对方式得分及生活质量总分高于对照组,且均有统计学意义(P<0.05);化疗脱发困扰总分及屈服应对方式得分低于对照组,且均有统计学意义(P<0.05);而化疗脱发困扰的生理困扰维度及回避应对方式得分差异无统计学意义(P>0.05)。结论:化妆美容能够有效改善患者化疗脱发困扰程度,引导其积极面对形象缺损,缓解屈服应对方式,最终提高生活质量。     

头部冷疗装置在乳腺癌患者化疗所致脱发中的应用效果

目的 探讨头部冷疗装置在乳腺癌患者化疗所致脱发中的应用效果.方法 选取2018年10月至2019年5月在我院普外科住院的60例乳腺癌患者为研究对象,将2018年10月至2019年1月住院的30例乳腺癌患者作为对照组,2019年2月至5月住院的30例乳腺癌患者作为观察组,其中对照组3例脱落,观察组2例脱落,最终对照组共纳...     

Scalp cooling: a qualitative study to assess the perceptions and experiences of Australian patients with breast cancer

Purpose

Chemotherapy-induced hair loss is a common and distressing side effect. Scalp cooling is increasingly being used to reduce this hair loss. The purpose of this study was to explore patients’ perceptions and experience of scalp cooling.

Methods

Seventeen Australian women with a diagnosis of breast cancer participated in a focus group (n = 4) or a semi-structured interview (n = 3). Both scalp-cooled and non-scalp-cooled participant views were sought. Participant perceptions and experiences of scalp cooling were discussed as part of patients’ overall chemotherapy experience and a thematic analysis conducted.

Results

Five themes emerged from the data: (1) scalp cooling in the context of treatment decision-making discussions, (2) hair loss expectations vs. experiences, (3) treatment-related expectations vs. experiences, (4) the promise of faster regrowth and (5) satisfaction with scalp cooling and future scalp cooling decision-making considerations. Information during treatment decision-making was the primary factor that influenced whether patient expectations were met. Faster regrowth was a motivator to continue treatment. Efficacy and tolerability of scalp cooling influenced future hypothetical treatment decision-making for both scalp-cooled and non-scalp-cooled participants.

Conclusions

This study provides the first in-depth exploration of patient attitudes to scalp cooling. The results highlight a need for accurate information regarding efficacy and tolerability as well as hair care information to assist patients with their treatment decision-making.

     

Preventing chemotherapy-induced alopecia in cancer patients: is scalp cooling worthwhile?

Alopecia (hair loss) is often singled out as the most distressing side-effect of cancer chemotherapy treatment. This paper provides a comprehensive and critical review of the research literature on scalp cooling, a procedure introduced to prevent chemotherapy-induced alopecia. In spite of a considerable amount of research (both nursing and medical) over a 15-year period, the evidence on scalp cooling is inconclusive. Although concerned with a specialist issue, this paper may interest the general reader as it illustrates the value of a literature review in raising questions about current practice and in identifying issues for future research.