个体化32P敷贴及介入治疗皮肤血管瘤的疗效观察及护理

目的 探讨选用个体化放射性核素32P敷贴及介入治疗皮肤血管瘤的疗效及其护理在治疗中的作用.方法 选取2004年12月至2009年4月诊治的皮肤血管瘤患者734例,应用个体化治疗方案及护理措施:按1 Gy·cm-2·d-1制备敷贴器,介入治疗按6.8～10.0μCi/cm2决定投药量,根据血管瘤的生长部位、患者年龄决定投放32P放射剂量,治疗间隔1.5～2.0个月.护理措施:进行有效沟通,解除顾虑,建立治疗信心;应用数码相机在治疗前后对病变处拍照,并行计算机存档后制成单人合并图,客观评价治疗效果;发放健康教育处方,提供书面指导;电话回访,接受咨询,提供指导,了解疗效.结果 734例患者治愈率78.88%,总有效率94.14%,单纯性血管瘤治疗效果最好,年龄与治疗效果呈负相关.针对性的护理使不良反应发生率明显减少.结论 应用个体化32P敷贴及介入治疗皮肤血管瘤疗效满意,在临床工作中应严格掌握32P的投药量,护理工作对提高治疗效果、减少不良反应发生起到了关键作用.

The clinical observation and nursing of personalized 32p application and interventional therapy in skin hemangioma

Objective To evaluate the therapeutic effect of 32P application and interventional therapy in skin hemangioma, and to sum up the role of nursing in the process of the treatment. Methods 734 cases of skin hemangiorna were involved in the study. Personalized treatment strategy and nursing measures were implemented according to different kinds of skin hernangioma, 32p application device was made with the dose of 1 Gy per square centimeter every day, and the total dose of interventional therapy was from 6.8μCi to 10.0μCi per square centimeter according to the site of lesions and the patients' age. The treatment interva] was about one and a haft month or two months. The specific nursing measures were as follows: effective communication should be undertaken to remove the concerns of patients before therapy. Meanwhile, the lesions should be taken a picture by a digital camera before and after therapy. Thus, the effect could be evaluated objectively. In addition, the follow-up by telephone also was done in the study. Results the cure rate and the effective rate of 32P in the treatment of skin hemangioma were 78.88% and 94.14% respectively.The treatment effect was the best in hemangioma simplex among different kinds of skin hemangioma. The treatment effect had a negative correlation with the age of the patients. Selective nursing reduced incidence of complication. Conclusions There's a satisfactory effect of 32p application and interventional therapy in the treatment of skin hemangioma. Meanwhile, nursing plays an important role in the treatment.