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。     

手术后肿瘤患者焦虑抑郁情绪的护理干预效果

目的探讨护理干预对手术后肿瘤患者焦虑抑郁情绪的影响。方法选取2011年3月至2014年10月间收治的168例肿瘤手术后焦虑、抑郁患者,按随机数字表法分为观察组和对照组,每组84例。对照组患者给予常规护理,观察组患者在常规护理的基础上给予护理干预。分别对两组患者入院和出院当天进行焦虑自评量表(SAS)和抑郁自评量表(SDS)评分,以评估患者心理状态,并在患者出院当天对其生活质量进行评估。结果出院时,两组患者SAS评分和SDS评分均较入院时评分结果显著下降,差异有统计学意义(P<0.05)。观察组患者出院时的SAS、SDS评分明显低于对照组,组间差异有统计学意义(P<0.05)。观察组患者护理干预后在躯体功能、角色功能、情绪功能、认知功能、社会功能、总体生活质量等方面的评分均显著高于对照组,差异有统计学意义(P<0.05)。结论护理干预可有效改善手术后肿瘤患者焦虑、抑郁状态,提高患者生活质量,值得临床推广应用。     

心理评量技术对骨肉瘤手术患者护理效果的影响

目的研究心理评量技术对骨肉瘤手术患者的护理效果影响。方法选取2013年3月至2016年6月间南通大学附属海安医院收治的72例骨肉瘤手术患者,采用随机数表法分为研究组和对照组,每组36例。对照组患者采用常规护理,研究组患者在对照组基础上使用心理评量技术评估心理状态,并根据评量结果进行针对性护理干预。采用生活质量量表(QOL-C30)评估两组患者护理前后的生活质量,采用焦虑自评量表(SAS)和抑郁自评量表(SDS)评价两组患者干预前后焦虑和抑郁情绪,记录患者不良反应发生情况,评估患者治疗依从性。结果干预后,两组患者躯体功能、心理功能、物质生活、社会状态等生活质量各评分均显著提高,且研究组患者各评分均显著高于对照组,差异均有统计学意义(均P<0.05)。护理后,两组患者焦虑和抑郁评分均降低,且研究组患者焦虑和抑郁评分(40.34±3.52和40.40±3.43)均低于对照组(46.23±4.21和45.63±4.48),差异均有统计学意义(均P<0.05)。研究组患者治疗依从性显著高于对照组,差异有统计学意义(P<0.05)。结论心理评量技术能够显著改善骨肉瘤手术患者的护理效果,提高生活质量及治疗依从性,改善负性情绪,值得临床推广。     

心理护理干预对晚期前列腺癌去势手术后合并焦虑抑郁症患者的临床效果

目的探讨心理护理干预对晚期前列腺癌去势手术后合并焦虑抑郁症患者的临床效果。方法选择2012年3月至2014年8月间收治的行去势手术治疗的晚期前列腺癌患者88例,采用随机数字表法分为观察组和对照组,每组44例。对照组患者给予常规护理,观察组患者则在常规护理的基础上给予心理护理干预。护理前后分别行焦虑自评量表(SAS)、抑郁自评量表(SDS)评分并对护理后患者的生活质量进行评估,比较两组结果。结果两组患者护理后SAS和SDS评分均显著下降,与护理前差异均有统计学意义(P<0.05)。观察组患者护理后SAS、SDS评分明显低于对照组,差异有统计学意义(P<0.05)。观察组患者治疗后在躯体功能、角色功能、情绪功能、认知功能、社会功能、总体生活质量6个方面的评分均显著高于对照组,差异有统计学意义(P<0.05)。结论心理护理干预可有效减轻晚期前列腺癌去势手术后合并焦虑抑郁症患者的不良情绪,改善患者的预后及生活质量,值得临床推广应用。     

陪护家属心理疏导对肝癌合并肾功能衰竭患者焦虑、抑郁情绪及自我管理效能的影响

目的 探讨陪护家属心理疏导对肝癌合并肾功能衰竭患者焦虑、抑郁情绪及自我管理效能的影响.方法 根据术后干预方式的不同将108例肝癌合并肾功能衰竭患者分为观察组(n=55,给予常规干预联合陪护家属心理疏导)和对照组(n=53,给予常规干预).干预前后,采用焦虑自评量表(SAS)和抑郁自评量表(SDS)评估两组患者的焦虑、抑郁状态;采用健康促进策略量表(SUPPH)评估两组患者的自我管理效能;采用中文版36条目简明健康状况调查问卷(SF-36)评估两组患者的生活质量.结果 干预后,观察组患者的SDS、SAS评分均低于对照组患者,差异均有统计学意义(P﹤0.05).干预后,观察组患者SUPPH量表中正性态度、自我减压、自我决策维度的评分及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,观察组患者SF-36量表中生理功能、生理职能、社会功能、躯体疼痛、情感职能、活力、精神健康、总体健康维度的评分均高于对照组,差异均有统计学意义(P﹤0.05).结论 陪护家属心理疏导干预模式可缓解肝癌合并肾功能衰竭患者的不良情绪,改善患者的自我管理效能和生活质量.     

晚期非小细胞肺癌化疗患者的焦虑抑郁状态评估及护理干预效果

目的探讨晚期非小细胞肺癌化疗患者的焦虑、抑郁状态评估及护理干预效果。方法选择我院2010年1月至2012年7月收治的81例晚期非小细胞肺癌化疗患者,按照随机数字表法分为两组,对照组40例采用常规化疗护理方法,观察组41例加强心理护理干预,比较分析两组患者的心理状态、生活质量改善情况。结果采用Zung焦虑量表(SAS)、抑郁量表(SDS)评定患者心理状态显示,护理前SAS、SDS评分组间差异无统计学意义(P>0.05),护理后观察组SAS、SDS评分均明显优于对照组(P<0.05);采用诺丁汉健康调查问卷(NHP)对两组患者的生活质量进行评价,护理前NHP评分组间差异无统计学意义(P>0.05),护理后观察组患者的NHP评分明显优于对照组,组间差异有统计学意义(P<0.05)。结论对晚期非小细胞肺癌化疗患者的焦虑、抑郁状态进行评估并加强针对性的心理护理干预,可以明显改善患者的心理状态及生活质量,提高晚期非小细胞肺癌化疗患者的生存质量。     

肿瘤复发对肠癌患者心理状态影响的观察

目的:评估根治术后发生肿瘤复发的肠癌患者的心理反应状况,为进一步探讨适合国人的中晚期肿瘤患者心理干预方案提供依据.方法:选择2003-01～2006-06在上海市长海医院肛肠外科确诊并随后于该院接受手术治疗的大肠癌患者为观察对象.试验组(肿瘤复发组)纳入160例患者,对照组(同时期肠癌术后未发现复发的患者)纳入167例患者.标准问卷有焦虑自评量表SAS、抑郁自评量表SDS和自编症状困扰自评量表10项问卷.采用SPSS 10.0统计学软件进行统计.结果:问卷收回有效率100%,均进入统计分析.两组患者的焦虑、抑郁评分却均高于中国人常模.试验组焦虑、抑郁评分在各个时段(复发确诊时、确诊后1、3和6个月)均高于对照组,差异有统计学意义,P<0.05;试验组患者有7项(睡眠障碍、食欲不振、体质量减轻、头痛、腹痛、疲倦和腹胀)测评项目评分显著高于对照组.差异有统计学意义,P<0.05;另外3项(便血、便秘和腹泻)与对照组相比,差异无统计学意义,P>0.05.讨论:肿瘤复发是一种强烈的心理刺激,可诱使肠癌患者产生激烈的心理应激反应并随之出现躯体化症状.在临床工作中应对此给予高度重视并将心理评估和干预贯穿于整个肿瘤的诊治过程中,以使患者能保持稳定、积极的心理状态配合治疗.     

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。     

系统性护理干预对中重度癌痛患者及家属生活质量的影响

目的探讨系统性护理干预对中重度癌痛患者及家属生活质量的影响。方法选取2013年9月至2015年7月间河北工程大学附属医院收治的94例肺癌晚期伴中重度癌痛患者,采用随机数表法分为观察组与对照组,每组47例。观察组患者给予系统性护理干预,对照组患者给予常规护理,干预一个月后,比较两组患者的癌痛缓解程度、依从性和治疗满意程度,采用焦虑自评量表(SAS)和抑郁自评量表(SDS)对患者焦虑和抑郁程度进行评价,并比较两组患者和家属的生活质量与心理状态。结果经过系统性护理干预后,观察组患者的依从性、癌痛缓解有效率及对治疗的总满意率,均显著高于对照组患者,两组组间比较,差异有统计学意义(P<0.05);两组患者疼痛视觉模拟评分表(VAS)、SAS和SDS评分均明显下降,且观察组各指标下降更明显,组间比较,差异有统计学意义(P<0.05);组内治疗前后比较,两组患者的食欲、睡眠、精神状态、日常活动、抑郁、焦虑、恐惧、消极和自信程度均有显著改善,差异有统计学意义(P<0.05);组间治疗后比较,除食欲外的上述指标均表现为观察组好于对照组,组间比较,差异有统计学意义(P<0.05);家属生活质量与心理状态治疗后比较,全部指标均表现为观察组好于对照组,差异有统计学意义(P<0.05)。结论系统性护理干预能改善中重度癌痛患者的依从性,缓解癌痛,提高患者的治疗满意度,并提高患者和家属的生活质量。     

心理支持护理联合健康促进在胃肠肿瘤患者中的应用

目的探究心理支持护理联合健康促进在胃肠肿瘤患者中的应用。方法选取2013年7月至2016年7月间江苏省东台市三仓人民医院收治的90例胃肠道肿瘤患者,采用随机数字表法分为观察组与对照组,每组45例。对照组患者给予常规护理,观察组患者在对照组基础上加用心理支持护理联合健康促进,对比两组患者的焦虑抑郁情绪、癌因性疲乏程度及生活质量。结果护理后,两组患者焦虑和抑郁评分与护理前比较均降低,且观察组降低更显著,差异均有统计学意义(均P<0.05)。护理后,两组患者躯体疲乏、情感疲乏及认知疲乏评分与护理前比较均降低,且观察组降低更显著,差异均有统计学意义(均P<0.05)。护理后,观察组患者生活质量各指标角色功能、躯体功能、心理功能及社会功能评分与对照组比较均较高,差异均有统计学意义(均P<0.05)。结论在常规护理基础上加用心理支持护理联合健康促进,可有效缓解患者的焦虑抑郁情绪,降低疲乏程度,改善生活质量。     

Bacteria and cancer--antagonisms and benefits

There is considerable historical and recent evidence concerning the antagonisms between acute bacterial infections or their toxins and cancer and allied diseases. These data provide renewed incentives to undertake clinical programmes with mixed bacterial vaccines in many countries at the present time.     

Religiosity and physical and emotional functioning among African American and White colorectal and lung cancer patients

The literature suggests that religiosity helps cope with illness. The present study examined the role of religiosity in functioning among African Americans and Whites with a cancer diagnosis. Patients were recruited from an existing study and mailed a religiosity survey. Participants (N = 269; 36% African American, 56% women) completed the mail survey, and interview data from the larger cohort was utilized in the analysis. Multivariate analyses indicated that in the overall sample religious behaviors were marginally and positively associated with mental health and negatively with depressive symptoms. Among women, religious behaviors were positively associated with mental health and negatively with depressive symptoms. Religiosity was not a predictor of study outcomes for men. Among African Americans, religious behaviors were positively associated with mental health and vitality. Among Whites, religious behaviors were negatively associated with depressive symptoms. These findings suggest a mixed role of religious involvement in cancer outcomes. The current findings may have applied potential in the areas of emotional functioning and depression.     

VEGF及KDR在大肠腺瘤和腺癌中的表达及意义

目的：探讨VEGF和KDR在大肠腺瘤和大肠腺癌中的表达及临床病理特征的关系。方法：大肠腺瘤和大肠腺癌组织标本各100例,采用免疫组织化学染色法检测VEGF和KDR在标本中的表达情况。结果：VEGF和KDR在大肠腺癌组中的阳性表达明显高于大肠腺瘤组（P〈0.05）;在正常大肠黏膜均未见VEGF和KDR表达的阳性染色;VEGF阳性表达组中KDR的阳性表达率为70%,显著高于VEGF阴性表达组中KDR的阳性表达率16%,两组比较有统计学意义（P〈0.01）。结论：大肠腺癌组织中KDR的表达与肿瘤大小、转移情况、浸润深度密切相关;VEGF和KDR在大肠腺瘤中的表达与患者的年龄、性别及分型均无相关性,而与增生程度相关（P〈0.05）。在大肠腺癌患者中VEGF及KDR表达更高,二者具有协同效应。     

Renal irradiation and the pharmacology and toxicity of methotrexate and cisplatinum

We used a rat model to study the effects of renal irradiation on the pharmacology of methotrexate (MTX) and cisplatinum (cis-Pt). Unanesthetized rats were given bilateral kidney irradiation (20 Gy in 9 fractions). At 9 months after irradiation, 3% of the animals had died and survivors showed moderately impaired renal function. At 15 months, 30% of the animals had died and survivors showed severely impaired renal function. Some animals were given i.v. MTX 1 week to 15 months after irradiation. In irradiated rats, the area under the MTX plasma clearance curve equaled that of controls through 6 months, and was significantly above controls from 9 months on. Other animals were given i.p. cis-Pt 1 week to 9 months after irradiation. The acute toxicity of cis-Pt was the same in control and irradiated rats when cis-Pt was given immediately before or after irradiation. Beginning 3 months after irradiation there was a progressive increase in cis-Pt toxicity and a simultaneous decrease in urinary platinum excretion. Irradiated animals that survived cis-Pt treatment showed increased radiation nephritis; the greatest effect occurred when cis-Pt was given 3 months or more after irradiation. MTX and cis-Pt clearance decreased when renal dysfunction was first observed and changes in renal function preceded changes in drug clearance and toxicity.     

Fruit and vegetables and cancer risk

The possibility that fruit and vegetables may help to reduce the risk of cancer has been studied for over 30 years, but no protective effects have been firmly established. For cancers of the upper gastrointestinal tract, epidemiological studies have generally observed that people with a relatively high intake of fruit and vegetables have a moderately reduced risk, but these observations must be interpreted cautiously because of potential confounding by smoking and alcohol. For lung cancer, recent large prospective analyses with detailed adjustment for smoking have not shown a convincing association between fruit and vegetable intake and reduced risk. For other common cancers, including colorectal, breast and prostate cancer, epidemiological studies suggest little or no association between total fruit and vegetable consumption and risk. It is still possible that there are benefits to be identified: there could be benefits in populations with low average intakes of fruit and vegetables, such that those eating moderate amounts have a lower cancer risk than those eating very low amounts, and there could also be effects of particular nutrients in certain fruits and vegetables, as fruit and vegetables have very varied composition. Nutritional principles indicate that healthy diets should include at least moderate amounts of fruit and vegetables, but the available data suggest that general increases in fruit and vegetable intake would not have much effect on cancer rates, at least in well-nourished populations. Current advice in relation to diet and cancer should include the recommendation to consume adequate amounts of fruit and vegetables, but should put most emphasis on the well-established adverse effects of obesity and high alcohol intakes.     

New and emerging radiosensitizers and radioprotectors

The combination of chemotherapy and radiation has led to clinical breakthroughs in several disease sites, and current work continues to define optimum combinations of proven chemotherapy as well as more recently available, noncytotoxic agents. Administration of systemic therapies allows modulation of radiation response to improve tumor control (radiosensitization) or to prevent normal tissue toxicity (radioprotection). Substantial progress has been made in identifying the targets of standard chemotherapeutic radiation sensitizers and protectors as well as in the introduction of a new generation of molecularly targeted therapies in combination with radiation. We have reviewed the most recent, predominantly early phase clinical trials combining systemic agents with radiation. Although the proof of an improved schedule ultimately needs to come from well-run Phase III trials, the search among schedules could be shortened by the use of surrogate endpoints such as presence of active drug metabolites in the tumor. This has been accomplished only in a few cases and needs to become a more standard part of radiation sensitizer and protector trials.