基于主观整体营养评分的个体化营养干预对胃癌术后化疗患者生活质量的影响

目的探讨基于主观整体营养评分量表(PG-SGA)的个体化营养干预对胃癌术后化疗患者生活质量的影响。方法选取2017年12月至2018年12月间榆林三院收治的82例行胃癌手术后化疗患者作为本次研究对象。采用随机数表法将患者分为观察组和对照组,每组41例。两组患者均行胃癌术后化疗常规护理,观察组患者在常规护理基础上行基于PG-SGA的个体化营养干预。比较两组患者护理干预后营养情况以及护理干预前后生活质量情况。结果干预后,对照组患者预后营养指数(PNI)低于治疗前,且观察组PNI指数高于对照组,差异均有统计学意义(均P <0. 05)。干预后,两组患者的躯体功能、角色功能、认知功能、情绪功能、社会功能和总体生活质量评分均上升,差异均有统计学意义(均P <0. 05);两组组间比较,观察组躯体功能、角色功能、认知功能、情绪功能、社会功能和总体生活质量评分均高于对照组,差异均有统计学意义(均P <0. 05)。干预后,两组患者症状维度评分下降,差异均有统计学意义(均P <0. 05);两组组间比较,观察组疲乏、疼痛和恶心呕吐评分低于对照组,差异均有统计学意义(均P <0. 05)。干预后,两组患者单项维度中呼吸困难、食欲丧失、便秘和腹泻评分均降低,差异均有统计学意义(均P <0. 05);两组组间比较,观察组呼吸困难、失眠和食欲丧失评分低于对照组,差异有统计学意义(P <0. 05)。结论基于PGSGA的个体化营养干预有助于改善胃癌术后化疗患者营养状态和生活质量。     

综合营养干预对晚期大肠癌化疗患者营养状况及生存质量的影响

目的:探讨综合营养干预对晚期大肠癌化疗患者营养状况及生存质量的影响。方法:选择晚期大肠癌患者100例,随机分为对照组和观察组各50例,对照组给予常规饮食,观察组在常规饮食基础上给予个体化膳食指导、教育及肠内肠外营养治疗等综合营养干预,对比治疗前后两组患者近期疗效、营养状况、免疫功能、生存质量及治疗依从性等结果变化。结果:经综合营养干预后,两组化疗有效率与毒副反应比较,差异均无统计学意义（P>0.05）;观察组在营养状况、免疫功能、生存质量及治疗依从性等方面优于对照组（P<0.05）,差异有统计学意义。结论:综合营养干预可有效改善晚期大肠癌化疗患者的营养状况、免疫功能、生存质量及治疗依从性,效果明显,值得临床推广应用。     

行为护理联合个体化营养对胃癌化疗患者营养状态和生活质量的影响

目的探讨行为护理联合个体化营养对胃癌化疗患者营养状态及生活质量的影响。方法选取2014年9月至2015年9月四川省内江市第六人民医院收治的120例胃癌化疗患者,采用随机数字表法分为观察组和对照组,每组60例。观察组患者采取行为护理联合个体化营养干预,对照组患者采取常规护理。比较两组患者的营养状态、焦虑评分和生活质量。结果观察组患者的血浆总蛋白、白蛋白和血红蛋白水平均明显高于对照组患者;观察组患者的焦虑评分显著低于对照组患者;观察组患者的生活质量各维度评分明显高于对照组患者,差异均有统计学意义(均P<0.01)。结论行为护理联合个体化营养可有效改善胃癌化疗患者的营养状态及焦虑情绪,提高生活质量。     

循证护理干预对胃癌化疗患者心理状况和并发症的影响

目的探讨循证护理干预对胃癌化疗患者心理状况和并发症的影响。方法选取2013年6月至2015年5月间泰山医学院附属医院收治的68例胃癌化疗患者,采用随机数字表法随机分成观察组和对照组,每组34例。观察组患者接受常规护理基础上的循证护理干预,对照组患者仅接受常规护理。比较两组患者护理前后的心理状况和并发症发生率。结果两组患者护理前焦虑、抑郁得分间差异无统计学意义(P>0.05)。护理后,观察组患者焦虑、抑郁得分均明显低于对照组,差异有统计学意义(P<0.05);观察组各并发症发生率均明显低于对照组,差异有统计学意义(P<0.05)。结论循证护理干预可有效改善胃癌化疗患者的心理状况,并降低并发症的发生率。     

护理干预对恶性肿瘤患者化疗依从性和生活质量及心理状况的影响

目的探讨护理干预对恶性肿瘤患者化疗依从性、生活质量及心理状况的影响。方法采用抽签法将100例恶性肿瘤化疗患者随机分为治疗组和对照组,每组50例。治疗组患者在肿瘤常规护理的基础上实施护理干预方法(包括入院后全面评估、化疗前心理干预、化疗不良反应护理干预、出院后护理指导),对照组患者仅给予肿瘤常规护理方法。观察护理干预前后两患者对化疗的依从性,并通过问卷调查患者生活质量及心理状况的变化。结果治疗组患者依从率为96.0%,对照组为76.0%,组间差异有统计学意义(P<0.05)。治疗组护理干预后总体生活质量维度和5个功能维度(躯体功能、角色功能、认知功能、情绪功能、社会功能)评分均明显高于护理干预前,差异有统计学意义(P<0.05)。治疗组的护理干预后3个症状维度(恶心、呕吐、疲乏、疼痛)和6个特异性条目(食欲下降、呼吸困难、腹泻、便秘、失眠、经济困难)评分显著低于护理干预前得分,差异有统计学意义(P<0.05)。对照组患者常规护理前后患者生活质量变化差异无统计学意义(P>0.05)。治疗组患者护理干预后的心理状况评分与护理前比较,差异有统计学意义(P<0.05)。对照组患者护理前后差异无统计学意义(P>0.05)。结论有效的护理干预能够提高肿瘤患者化疗依从性,提高患者生活质量,改善患者心理健康状况。     

营养状况评估干预对晚期结肠癌患者免疫功能及生存状况的影响

目的探讨营养状况评估干预对晚期结肠癌患者免疫功能及生存状况的影响。方法选取2014年3月至2015年3月间四川省宜宾市第一人民医院收治的87例晚期结肠癌患者,采用随机数表法将患者分为观察组(45例)和对照组(42例),观察组患者采取营养状况评估干预,对照组患者采取常规护理模式,比较两组患者干预后营养风险、营养指标、免疫功能及生存情况。结果干预3个月后,对照组患者潜在或存在营养风险率为42.9%,显著高于观察组患者的20.0%,组间比较,差异有统计学意义(P<0.05)。干预前两组患者体重指数及白蛋白比较,差异无统计学意义(P>0.05),干预后两组患者体重指数及白蛋白水平均显著升高,且观察组患者体重指数及白蛋白水平均高于对照组患者,组间比较,差异均有统计学意义(均P<0.05)。两组患者干预前细胞免疫功能比较,差异无统计学意义(P>0.05),干预后,除CD3+外,两组患者其他细胞免疫功能均较干预前显著改善,且观察组显著优于对照组,两组组间比较,差异有统计学意义(P<0.05)。观察组患者生存情况显著优于对照组患者,差异有统计学意义(P<0.05)。结论营养状况评估护理干预能有效改善晚期结肠癌患者营养状况,提高患者机体免疫功能,并改善患者生存情况,值得临床推广使用。     

综合护理干预对胃癌患者化疗依从性与营养状态的影响

目的探讨综合护理干预对胃癌化疗患者化疗依从性与营养状态的影响。方法选取2014年2月至2016年2月间大连医科大学附属大连市中心医院收治的104例胃癌患者作为研究对象,采用随机数表法分为研究组和对照组,每组52例。研究组患者在常规护理基础上采用综合护理,对照组患者采用常规护理。观察并比较两组患者的化疗依从性、治疗后体质量降低百分率和治疗前后的营养指数(PNI)。结果研究组患者化疗依从率为98.1%,高于对照组患者80.8%,差异有统计学意义(P<0.05)。两组患者治疗前PNI比较,差异无统计学意义(P>0.05)。化疗后,研究组患者体质量降低的百分率为(11.2±1.5)%,低于对照组患者的(6.7±0.8)%,研究组患者的PNI为(46.5±6.2),高于对照组患者的(42.8±5.5),差异均有统计学意义(均P<0.05)。结论综合护理干预措施能够提高胃癌化疗患者的化疗依从性,同时也可改善患者营养状况,适于临床推广与应用。     

综合性护理对胃癌患者化疗效果、免疫功能及生活质量的影响

目的探讨综合性护理对胃癌患者化疗效果、免疫功能及生活质量的影响。方法选取2014年1月至2015年8月间北京大学肿瘤医院收治的60例胃癌化疗患者,采用随机数字表法分为观察组与对照组,每组30例。观察组患者采用综合性护理,对照组患者采用常规护理。对比两组患者护理前后的治疗效果、免疫功能和生活质量。结果护理前,两组患者免疫球蛋白IgG、IgM、IgA及生活质量评分,差异均无统计学意义(均P>0.05);护理后,观察组患者IgG、IgM、IgA及生活质量评分均明显高于对照组,差异均有统计学意义(均P<0.05)。观察组患者治疗总有效率为76.7%,高于对照组患者的50.0%,差异有统计学意义(P<0.05)。结论综合性护理能有效提高胃癌化疗患者的治疗效果,改善其免疫功能和生活质量。     

综合护理干预对肺癌患者术后自我护理能力和生活质量的影响

目的探讨综合护理干预对肺癌患者术后自我护理能力和生活质量的影响。方法选取2011年1月至2015年1月间陕西省肿瘤医院收治的150例行开胸手术的肺癌患者,采用随机数表法分为试验组和对照组,每组75例。试验组患者在常规护理基础上行综合护理干预,对照组患者行常规护理,比较两组患者干预前后肿瘤生存质量调查表(EORTC)得分、自我护理能力量表(ESCA)得分和自我护理不良情况。结果试验组患者自我护理能力量表各方面评分均明显高于对照组,差异均有统计学意义(均P<0.05)。对照组患者自我护理事故比率为24.0%,明显高于试验组的2.7%,差异有统计学意义(P<0.05)。干预后,试验组患者肿瘤生存质量调查表7个方面评分均明显高于干预前及对照组干预后,差异均有统计学意义(均P<0.05)。结论综合性护理干预能有效地提高肺癌患者术后的自我护理能力和生活质量水平,值得在临床上推广。     

个体化系统营养护理用于胃癌化疗患者中的效果探讨

目的 探讨个体化系统营养护理应用于胃癌化疗患者中的效果.方法 选取2019年1月至2020年12月期间河南省人民医院收治的经病理学确诊并行常规化疗的胃癌患者60例作为研究对象,随机抽签分为对照组和观察组,每组30例,对照组实施常规护理,观察组在此基础上实施个体化系统营养护理,采取主观综合性营养评价量表比较观察2组患者的...     

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.     

Skeletal sequelae of cancer and cancer treatment

Introduction  Survivors of cancer may experience lingering adverse skeletal effects such as osteoporosis and osteomalacia. Skeletal disorders are often associated with advancing age, but these effects can be exacerbated by exposure to cancer and its treatment. This review will explore the cancer and cancer treatment-related causes of skeletal disorders. Methods  We performed a comprehensive search, using various Internet-based medical search engines such as PubMed, Medline Plus, Scopus, and Google Scholar, for published articles on the skeletal effects of cancer and cancer therapies. Results  One-hundred-forty-two publications, including journal articles, books, and book chapters, met the inclusion criteria. They included case reports, literature reviews, systematic analyses, and cohort reports. Skeletal effects resulting from cancer and cancer therapies, including hypogonadism, androgen deprivation therapy, estrogen suppression, glucocorticoids/corticosteroids, methotrexate, megestrol acetate, platinum compounds, cyclophosphamide, doxorubicin, interferon-alpha, valproic acid, cyclosporine, vitamin A, NSAIDS, estramustine, ifosfamide, radiotherapy, and combined chemotherapeutic regimens, were identified and described. Skeletal effects of hyperparathyroidism, vitamin D deficiency, gastrectomy, hypophosphatemia, and hyperprolactinemia resulting from cancer therapies were also described. Discussion/Conclusions  The publications researched during this review both highlight and emphasize the association between cancer therapies, including chemotherapy and radiotherapy, and skeletal dysfunction. Implications for cancer survivors  These studies confirm that cancer survivors experience a more rapid acceleration of bone loss than their age-matched peers who were never diagnosed with cancer. Further studies are needed to better address the skeletal needs of cancer survivors.     

Endocrine sequelae of cancer and cancer treatments

Introduction Exposure to cancer and its treatments, including chemotherapy and radiotherapy, may result in late adverse effects including endocrine dysfunction. Endocrine disorders are the most commonly reported long-term complications of cancer treatment, especially by adult survivors of childhood cancers. This review will explore the endocrinologic adverse effects from non-endocrine cancer therapies. Methods Searches including various Internet-based medical search engines such as PubMed, Medline Plus, and Google Scholar were conducted for published articles. Results One hundred sixty-nine journal articles met the inclusion criteria. They included case reports, systematic analyses, and cohort reports. Endocrine disorders including hypothalamus dysfunction, hypopituitarism, syndrome of inappropriate anti-diuretic hormone secretion, diabetes insipidus, growth hormone disorders, hyperprolactinemia, gonadotropin deficiency, serum thyroid hormone-binding protein abnormalities, hypothyroidism, hyperthyroidism, hypomagnesium, hypocalcemia, hyperparathyroidism, hyperparathyroidism, adrenal dysfunction, gonadal dysfunction, hypertriglyceridemia, hypercholesterolemia, diabetes mellitus, and glycosuria were identified and their association with cancer therapies were outlined. Discussion/conclusions The journal articles have highlighted the association of cancer therapies, including chemotherapy and radiotherapy, with endocrine dysfunction. Some of the dysfunctions were more often experienced than others. Especially in patients treated with radiotherapy, some endocrinologic disorders were progressive in nature. Implications for cancer survivors Recognition and awareness of endocrine sequelae of cancer treatments may permit for early detection and appropriate follow-up care for cancer survivors, thus improving their overall health and quality of life.     

前列腺癌和乳腺癌的对比性研究

人体一些肿瘤的生长对某些激素有一定的依赖关系,激素阻断可抑制其生长,被称为激素相关性肿瘤,如甲状腺癌、乳腺癌、子宫内膜癌及前列腺癌等.其中前列腺癌和乳腺癌为人群中发病率较高的两种恶性肿瘤,在很多方面均具有类似的特点.将二者在各方面进行对比性研究,有利于总结前列腺癌治疗方案,提高治疗效果.     

Family history of cancer among cancer patients

Family history of cancer was examined for 9,131 cancer patients who were reported to the Aichi Cancer Registry in 1979-1981, and were over 20 years old at diagnosis. The rate of patients whose parents and/or siblings had cancer of any site was 24.5%. The rate was 9.2% for father, 8.4% for mother, 6.0% for brother(s), and 5.2% for sister(s). A significant site concordance between study patient and family member with cancer was observed for cancer of the breast, colon and rectum, and stomach. The rate of family history of breast cancer patients was 3.3 times higher than the corresponding rate for other cancer patients (3.1% vs 0.9%). Similarly, the ratio was 2.2 in colon and rectum cancer (4.2% vs 1.9%), and 1.6 in stomach cancer (16.5% vs 10.1%). An increased risk of cancer was observed when both brother and sister had cancer. This may suggest an important role of environmental exposure at an early age, as well as genetic factors, in the development of cancer. The age distribution curve of the colon and rectum cancer patients who had a family history of the same cancer was found to be bimodal with the larger peak in the 40s and the smaller peak in the 70s. This may suggest a differential contribution of genetic and environmental factors to the development of colon and rectum cancer.     

Notification of cancer in breast cancer patients

The notification of the name of disease is a premise for making the system of informed consent more complete in case of cancer treatment. In Japan, however, the notification of cancer can hardly be said to have an attained social consensus. Considering that the notification can ultimately improve patients quality of life (QOL), the breast cancer group of our department informs all breast cancer patients of their diseases in principle. This paper reports and discusses the results of a survey by questionnaire on the notification of cancer in 100 patients with breast cancer. The notification of cancer was received favorably in 83% of the patients. For those who answered, the explanation on the notification was convincing and it accounted for 81%. An examination of background factors of patients who had not been convinced revealed that many of them were suffered from advanced cancer. After the notification, a human relationship with the family and friends aggravated few of them and improved in 30% (family) and 18% (friends), respectively. The notification of cancer was thus suggested to contribute to the improvement of QOL. Although 83% well received the notification of their own diseases, only 21% were affirmative for the notification of cancer in case of a member of the family. We medical professionals should make a further effort not to make the notification of cancer the pronouncement death but to make it an aid for patients to live better.     

Malignant transformation of thyroid cancer; poorly differentiated cancer and anaplastic cancer transformation

The prognosis of thyroid cancer depends largely on histological differentiation and clinical stage. The prognosis in anaplastic cancer is worst, in well differentiated cancer it is best; poorly differentiated cancer takes a middle position. The prognosis of patients with differentiated cancer is generally good, however, there are cases with malignant transformation such as poorly differentiated, anaplastic and squamous-cell cancer transformation. We studied the frequency and the inducement factors of malignant transformation in patients with thyroid cancer. The frequency of poorly differentiated, anaplastic and squamous-cell cancer transformation was 13.6%, 6.4% and 0.7%, respectively. In anaplastic cancer transformation, irradiation is an important factor.