心理护理对宫颈癌术后放疗患者癌因性疲乏的干预效果

目的探讨心理护理对宫颈癌术后放疗患者癌因性疲乏的干预效果。方法选取2014年3月至2015年3月间收治的88例宫颈癌术后放疗出现癌因性疲乏的患者,采用随机数表法分为观察组和对照组,每组44例。观察组患者采取常规护理结合心理护理干预,对照组患者采取常规护理。比较两组患者干预前后的癌因性疲乏状况以及生活质量情况。结果干预前,两组患者的癌因性疲乏状况、总体生活质量评分和症状子量表总分的差异均无统计学意义(P>0.05)。干预后,观察组患者的Piper疲乏修定量表(RPFS)平均分显著优于对照组,RPFS评分为重度的人数更低,总体生活质量评分显著高于对照组,且症状子量表总分更低,差异均有统计学意义(P<0.05)。结论针对宫颈癌术后放疗患者癌因性疲乏应用心理护理的干预,能减缓放疗过程中患者癌因性疲乏症状的加重,减少重度患者,减缓不良症状,相对提高生活质量。     

积极心理暗示疗法对宫颈癌患者负性情绪、癌因性疲乏及生活质量的影响

目的 探讨积极心理暗示疗法对宫颈癌患者负性情绪、癌因性疲乏及生活质量的影响.方法 根据干预模式的不同将128例宫颈癌患者分为对照组(n=64,采用常规干预模式)和观察组(n=64,在对照组的基础上给予积极心理暗示疗法),比较两组患者干预前后的负性情绪、癌因性疲乏程度及生活质量.结果 干预后,观察组患者的焦虑自评量表(SAS)评分、抑郁自量表(SDS)评分、Piper疲乏修正量表(RPFS)各维度评分均低于对照组,生活质量各维度评分均高于对照组,差异均有统计学意义(P﹤0.05).结论 积极心理暗示疗法能够减轻宫颈癌患者的负性情绪,缓解癌因性疲乏程度,提高患者的生活质量,值得临床重视.     

基于冰山理论的个性化护理在宫颈癌根治术患者中的应用

目的探讨基于冰山理论的个性化护理在宫颈癌根治术患者中的应用效果。方法选取2016年1月至2018年1月间湖北省荆门市第二人民医院收治的69例行宫颈癌根治术患者。其中,采用常规护理的34例患者纳入对照组,在常规护理基础上给予基于冰山理论的个性化护理的35例患者纳入观察组。比较两组患者干预前后生活质量(KPS评分)、焦虑情绪(SAS评分)、术后性生活质量和护理工作满意度。结果干预6个月后,两组患者的生活质量和负性情绪均得到不同程度改善,且观察组患者的SAS评分较对照组患者低,KPS评分较对照组患者高,差异均有统计学意义(均P <0. 05)。观察组患者性心理、性生理及夫妻关系方面优于对照组患者,差异均有统计学意义(均P <0. 05)。观察组患者护理工作满意度为94. 3%高于对照组患者的70. 6%,差异有统计学意义(P <0. 05)。结论给予宫颈癌根治术患者基于冰山理论的个性化护理可缓解其焦虑情绪,且患者生活质量及性生活质量均显著提升,患者对护理工作满意度高。     

综合护理干预对非小细胞肺癌化疗患者癌因性疲乏和不良反应的影响

目的探讨综合护理干预对非小细胞肺癌(NSCLC)化疗患者癌因性疲乏和不良反应的影响。方法将300例NSCLC化疗患者按照随机数表法分为观察组和对照组,每组150例。对照组给予常规护理,观察组给予综合护理干预,比较两组患者的负性情绪、癌因性疲乏(CRF)程度和不良反应发生率。结果化疗后,观察组焦虑调查表(SAS)、抑郁调查表(SDS)评分分别为(36.68±6.82)分和(38.57±7.71)分,均低于对照组,差异有统计学意义(P<0.05)。观察组Piper疲乏量表(PFS)总分及各维度评分均高于对照组,差异有统计学意义(P<0.05)。观察组的骨髓抑制、皮肤黏膜损伤、过敏反应、消化道不良反应发生率均低于对照组,差异有统计学意义(P<0.05)。结论综合护理干预减轻了患者负性情绪,降低了不良反应发生率,缓解了患者癌因性疲乏程度,值得临床重视。     

身心康复锻炼对宫颈癌患者癌因性疲乏及膀胱功能锻炼效果观察

目的探讨身心康复锻炼对宫颈癌患者癌因性疲乏及膀胱功能锻炼的效果影响。方法选取2017年2月至2018年1月间西北妇女儿童医院收治的88例宫颈癌患者,采用随机数表法随机分为观察组和对照组,每组44例。对照组患者采用常规护理,观察组患者在常规护理基础上采用身心康复锻炼,比较两组患者癌因性疲乏评分及膀胱功能变化情况。结果护理后,两组患者躯体疲乏、情感疲乏和认知疲乏评分均低于护理前,且观察组患者低于对照组,差异均有统计学意义(均P <0. 05)。观察组患者术后尿潴留和再置尿管发生率均低于对照组,自解小便发生率高于对照组,膀胱功能分级优于对照组,两组比较,差异均有统计学意义(均P <0. 05)。结论身心康复锻炼用于宫颈癌患者能有效降低患者癌因性疲乏,改善膀胱功能,减少术后尿潴留及再次置管发生风险。     

协同护理对非小细胞肺癌化疗患者自我护理能力、癌因性疲乏和生活质量的影响

目的探讨协同护理模式对非小细胞肺癌(NSCLC)化疗患者自我护理能力、癌因性疲乏和生活质量的影响。方法选取2010年1月至2017年1月间南充市中心医院嘉陵院区收治的行化疗治疗的96例NSCLC患者,按照护理方法不同分为观察组和对照组,每组48例。患者均予以临床对症治疗,对照组患者采用常规临床护理干预,观察组患者采用协同护理模式干预,比较两组患者自我护理能力、癌因性疲乏、生活质量及护理满意度。结果干预后,观察组患者自我护理能力评分提高程度明显大于对照组,癌因性疲乏评分降低程度明显大于对照组,两组比较,差异均有统计学意义(均P<0.05)。干预后,观察组患者生活质量评分较对照组明显提高,差异有统计学意义(P<0.05)。观察组患者护理总满意度为95.8%,明显高于对照组的79.2%,差异有统计学意义(P<0.05)。结论协同护理模式可明显减轻NSCLC化疗患者的癌因性疲乏程度,提高自我护理能力和生活质量,值得临床推广。     

三焦针灸法对中晚期胃腺癌癌因性疲乏的疗效及对免疫功能的影响

目的 观察三焦针灸法治疗中晚期胃腺癌癌因性疲乏的疗效及对免疫功能的影响。方法 收集2019年1月至2020年12月天津中医药大学第一附属医院收治的中晚期胃腺癌癌因性疲乏患者200例。应用随机数字表法将患者分为对照组和治疗组各100例；剔除脱落患者后，对照组85例，治疗组77例。对照组接受常规中西医对症治疗，治疗组在此基础上联合三焦针灸法治疗。观察两组治疗前后的卡氏功能状态(Karnofsky performance status,KPS)评分、Piper量表评分、红细胞计数、血红蛋白浓度以及淋巴细胞亚群(CD3⁺T细胞、CD4⁺T细胞、CD8⁺T细胞、NK细胞和B细胞)百分比和绝对计数的变化。结果 对照组治疗后KPS评分升高且Piper量表中行为维度评分、红细胞计数、血红蛋白浓度和淋巴细胞亚群CD4⁺T细胞绝对计数均下降，差异均具有统计学意义(均P<0.05)。对照组治疗前后Piper量表中情绪维度、感觉维度、认知维度和总分评分以及淋巴细胞亚群百分比、CD3⁺T细胞绝对计...     

子宫内膜癌患者癌因性疲乏现状调查及护理对策研究

目的探讨子宫内膜癌患者癌因性疲乏现状及护理对策制定。方法选取2017年5月至2020年5月间湖南省妇幼保健院收治的150例子宫内膜癌患者,采用随机抽签法分为观察组和对照组,每组75例。观察组患者采用针对性护理,对照组患者采用常规护理,比较两组患者护理前后癌因性疲乏评分和负面情绪评分。结果患者癌因性疲乏总评分为(99.34±3.11)分,条目总评分为(4.79±1.34)分。护理后,两组患者癌因性疲乏评分均降低,且观察组患者低于对照组,差异均有统计学意义(均P<0.05)。护理后,两组患者SAS和SDS评分均降低,且观察组患者低于对照组,差异均有统计学意义(均P<0.05)。结论子宫内膜癌患者普遍存在癌因性疲乏,进行针对性护理干预,可缓解其癌因性疲乏状况,改善负面情绪,具有临床推广价值。     

综合干预对晚期卵巢癌患者生活质量、心理状态及癌因性疲乏的影响

目的探讨综合干预对晚期卵巢癌患者生活质量、心理状态及癌因性疲乏的影响。方法随机数字表法将86例晚期卵巢癌患者对照组和研究组,每组43例,对照组患者给予常规护理干预,研究组患者在常规护理干预的基础上给予综合干预。采用生活质量综合评定问卷(GQOLI-74)评估两组患者的生活质量,采用癌症疲乏量表(CFS)评估两组患者的癌因性疲乏程度,采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评估两组患者的心理状态。结果干预前,两组患者GQOLI-74、CFS、HAMD、HAMA量表评分比较,差异均无统计学意义(P﹥0.05)。干预后,两组患者物质功能、社会功能、心理功能、躯体功能评分以及GQOLI-74总分均高于本组干预前,且研究组患者物质功能、社会功能、心理功能、躯体功能评分及GQOLI-74总分均高于对照组患者,差异均有统计学意义(P﹤0.05)。干预后,研究组患者认知疲乏、情感疲乏、躯体疲乏评分及CFS总分均低于本组干预前和对照组患者,对照组患者躯体疲乏评分及CFS总分均低于本组干预前,差异均有统计学意义(P﹤0.05)。干预后,研究组患者HAMD、HAMA评分均低于对照组患者,差异均有统计学意义(P﹤0.05)。结论综合干预可以进一步改善患者的生活质量及心理状态,并减轻患者的癌因性疲乏程度。     

微波理疗联合运动干预对宫颈癌患者的疗效观察

目的探讨微波理疗联合运动干预在宫颈癌患者中的临床效果及对行为转变的影响。方法选取2016年1月至2019年12月间荔湾区中医医院收治的78例宫颈癌患者为对象,根据治疗方法不同进行分组。采用运动干预的39例患者纳入对照组,在运动干预基础上联合微波理疗的39例患者纳入观察组。6个月后评估患者治疗效果,比较两组患者的行为转变、癌因疲乏因子、治疗依从性及满意度。结果干预6个月后,观察组宫颈癌危险因素、宫颈癌早期症状、遵医用药治疗、克服生理障碍和克服家庭影响评分均高于对照组,差异均有统计学意义(均P<0.05)。两组患者癌因疲乏因子评分低于干预前,观察组情绪、感觉、行为及认知评分均低于对照组,差异均有统计学意义(均P<0.05);观察组按时治疗、遵医锻炼、定期复查依从性和康复效果、护患沟通及服务态度满意度均高于对照组,差异均有统计学意义(均P<0.05)。结论微波理疗联合运动干预用于宫颈癌患者中,能提高患者健康行为,降低癌因疲乏因子水平,有助于提高患者治疗依从性及满意度,值得推广应用。     

Preoperative cancer chemotherapy for gastric cancer

Preoperative cancer chemotherapy for gastric cancer was reviewed with special emphasis on histologic findings and survival. Preoperative chemotherapy with intravenous, split administration of MMC 40 mg caused considerable damage to "micro-solitary metastatic foci" in metastatic lymph nodes. In view of the lipid-adsorbing ability of the lymphatic stream, emulsified 5-FU was used orally in 182 patients with gastric cancer; histologic findings revealed that the emulsified 5-FU enhanced the antitumor efficacy for metastatic lymph nodes as well as the primary lesion. However, the 5-year survival rate for gastric cancer patients undergoing preoperative emulsified 5-FU therapy did not differ from the control, with only the exception of patients with Stage III gastric cancer. On the other hand, combined therapy involving preoperative intra-arterial infusion and surgery was carried out in 62 patients with gastric cancer. These preoperative treatments using MMC, 5-FU, VLB, MTX and/or cytosine arabinoside entailed continuous infusion for 15 to 20 hours; the histologic changes observed revealed marked antitumor effects on the primary focus as well as metastatic lymph nodes. The five-year survival rate for the 62 patients was compared with that for 99 patients with gastric cancer in the corresponding period. The survival rate was analyzed based on the degree of serosal invasion. The overall survivals in the 62 patients were higher than those in the controls for the first 3 years. At 4 to 5 years, the survival rates for both the treated and control groups were approximately equal. In patients without serosal invasion, the survival rates were higher in treated cases than in the controls for the first 2 years. Thirty-nine patients with serosal invasion had significantly higher survival rates than the controls for the first 3 years. The survival rates for the treated patients with cancerous infiltration of ther organs were about the same as those for the corresponding control patients.     

Anal cancer: an HIV-associated cancer

Although not yet included in the Centers for Disease Control definition of AIDS, anal cancer clearly occurs more commonly in HIV-infected patients. An effective screening program for those groups who are at highest risk might be expected to impact rates of anal cancer just as significantly as did cervical Pap screening programs for the incidence of cervical cancer. Despite a relatively low rate of progression from AIN to invasive cancer, the scope of the problem is enormous based on the prevalence of anal HPV infection and the size of the HIV-infected, at-risk population. Thus, the potential benefits of screening, detection, and the development of more effective therapy also are enormous. Currently, therapeutic HPV vaccines for AIN represent an exciting avenue of research in HPV-related anogenital disease. Invasive anal cancer and HSIL (which is believed to be the precursor lesion) are expected to become increasingly important health problems for both HIV-infected men and women as their life expectancy lengthens. Although HAART may have improved the ability of many to tolerate CMT, it appears that toxicity of this therapy continues to be a problem for a proportion of HIV-infected subjects. The acute side effects present specific challenges to the clinician and patient, have an immediate impact on the patient's plan of care and dose intensity of the treatment, and ultimately may impact the outcome of the planned treatment. Late toxicity may influence the long-term quality of life. Small patient numbers, variable radiation therapy doses, limited information about viral load, and a potential confounding effect of higher CD4+ levels make it difficult to draw any conclusions about the effect of HAART on anal cancer outcome. Large, prospective studies will be required before solid conclusions about the impact of various factors on anal cancer prognosis and outcome can be drawn.     

Familial cancer and cancer families.

From this brief review is should be evident that the hereditary varieties of common cancers are characterized by a high degree of genetic heterogeneity. The specific types of hereditary cancers can be identified by focusing on the histologic types and sites of involvement, not only of the primary neoplasm, but also of associated neoplasms and associated conditions or stigmata, as well as by focusing on the age of the patient at the time of diagnosis, tumor localization and frequency, and the mode of inheritance. Identification of specific types of hereditary cancers has important utility as a means of isolating homogeneous groups of patients and unaffected relatives for studies aimed at elucidating the mechanisms of carcinogenesis.     

Breast cancer associated with other organ cancer reviewed from cancer family history

Double cancers and related family histories were studied in eight patients who had developed cancers in the breasts and other organs. The incidence of double cancer among patients with breast cancer was 1.7% (8/472), and the age at first onset averaged 48. The organs involved were mainly the digestive system, thyroid and female sexual organs. The incidence of cancer was higher in the pedigree of double breast cancer patients than in those with solitary cancer. In follow-up study, it is necessary to elucidate the difference in characteristics between double and solitary breast cancer.     

Oral complications of cancer and cancer therapy

Answer questions and earn CME/CNE Oral complications resulting from cancer and cancer therapies cause acute and late toxicities that may be underreported, underrecognized, and undertreated. Recent advances in cancer treatment have led to changes in the incidence, nature, and severity of oral complications. As the number of survivors increases, it is becoming increasingly recognized that the aggressive management of oral toxicities is needed to ensure optimal long‐term oral health and general well‐being. Advances in care have had an impact on previously recognized oral complications and are leading to newly recognized adverse effects. Here, the authors briefly review advances in cancer therapy, including recent advances in surgery, oral care, radiation therapy, hematopoietic cell transplantation, and medical oncology; describe how these advances affect oral health; and discuss the frequent and/or severe oral health complications associated with cancer and cancer treatment and their effect upon long‐term health. Although some of the acute oral toxicities of cancer therapies may be reduced, they remain essentially unavoidable. The significant impact of long‐term complications requires increased awareness and recognition to promote prevention and appropriate intervention. It is therefore important for the primary oncologist to be aware of these complications so that appropriate measures can be implemented in a timely manner. Prevention and management is best provided via multidisciplinary health care teams, which must be integrated and communicate effectively in order to provide the best patient care in a coordinated manner at the appropriate time. CA Cancer J Clin 2012. © 2012 American Cancer Society.     

靶向肿瘤干细胞治疗肿瘤

具有独特的分子表达、表面标志物、干性相关信号通路和代谢模式等方面特征的肿瘤干细胞（cancer stem cell, CSC） 因其具有高致瘤、高转移、高治疗抵抗能力,可能是多种类型恶性肿瘤生长、转移、治疗抵抗的关键因素,也是肿瘤发生和复发的 重要根源。正常干细胞在产生了第一个致癌突变之后将逐步发展成为癌前干细胞和CSC,随后在突变和微环境的共同作用下进 一步积累突变增加异质性,并与CSC可塑性转变交织在一起推动肿瘤的发生和进展,促进肿瘤的复发、转移及治疗抵抗。为了更 好地治疗肿瘤,现已研发了多种类型的靶向CSC的治疗策略,包括靶向CSC的细胞表面标志物、信号转导途径、微环境、代谢模式 等,以及促CSC分化、靶向CSC的免疫治疗等其他策略。多个靶向CSC治疗肿瘤的新药在临床试验中已经展现出良好的治疗效 果,然而,也有一些抗肿瘤新药的失败为未来研发提供了值得注意的教训。未来肿瘤治疗中,特异地靶向患者肿瘤中所有异质性 的CSC,并同时清除癌前干细胞和子代肿瘤细胞,将会更好地抑制肿瘤生长、转移和复发,从而为治愈肿瘤带来新的希望。