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醫(yī)學(xué)論文范文:吉西他濱同步三維適形放療治療老年晚期非小細(xì)胞肺癌的護(hù)理
【摘要】 目的 總結(jié)吉西他濱同步三維適形放療治療老年晚期非小細(xì)胞肺癌的護(hù)理經(jīng)驗(yàn)。方法 64例老年晚期非小細(xì)胞肺癌在三維適形放療1周后,用吉西他濱0.8～1 g/m2 靜脈滴注,在放療第1天、8天、15天、22天以周劑量方式進(jìn)行治療。用腫瘤治療毒性反應(yīng)評分標(biāo)準(zhǔn)進(jìn)行觀察評估,并給予醫(yī)療護(hù)理干預(yù)。結(jié)果 64例患者中發(fā)生不同程度毒性反應(yīng),白細(xì)胞減少、血小板下降、惡心、嘔吐,放射性肺炎、食管炎等發(fā)生率較高,但均完成治療計(jì)劃。結(jié)論 做好心理護(hù)理、預(yù)防感染、毒性反應(yīng)觀察與護(hù)理是控制和減少毒性反應(yīng)發(fā)生的必要手段,可以保證治療方案順利進(jìn)行。
【關(guān)鍵詞】 吉西他濱;非小細(xì)胞肺癌;適形放療;護(hù)理
The nursing experience of treating the advanced nonsmall cell lung cancer of the elderlyby Gemcitabine combined with threedimensional conformal radiotherapySHANG Xiuzhen (Dept. of Radiotherapy, Taian City Central Hospital,Taian 271000, China)Abstract:Objective:To summarize the nursing experience of treating the advanced nonsmall cell lung cancer of the elderly by Gemcitabine combined with threedimensional conformal radiotherapy. Methods: Gemcitabine 0.8～1 g/m2 intravenous drip was given at d1,d8,d15,d22 one week after 64 elder patients with advanced nonsmall cell lung cancer(NSCLC)were treated by threedimensional conformal radiotherapy. One cycle consisted of one week. Results: 64 cases of NSCLC showed toxic reaction in different degrees. The incidence rate of WBC descent, platelet decreasing, nausea, vomiting, radiation pneumonitis and esophagitis is higher, but all patients achieved the treatment plan successfully. Conclusion: To make good psychology nursing, preventing infection, observation and nursing of toxicity effect become necessary means of controlling and reducing toxicity. It can guarantee the smooth progress of the treatment plan醫(yī)學(xué)全.在線www.gydjdsj.org.cn.
Key words:gemcitabine; nonsmall cell lung cancer; conformal radiotherapy; nursing
非小細(xì)胞肺癌(NSCLC)是常見惡性腫瘤之一,50%以上肺癌患者診斷時(shí)年齡超過65歲,約1/3年齡大于70歲，就診時(shí)絕大多數(shù)患者因病情已屬晚期、一般狀況差及并發(fā)癥較多等原因失去手術(shù)機(jī)會而采用以放、化療為主的綜合治療。含鉑類的聯(lián)合化療被認(rèn)為是有效的治療，但多數(shù)70歲以上的老年晚期非小細(xì)胞肺癌患者心、肝、腎等重要臟器的生理功能相對低下，對聯(lián)合化療的耐受性較差。我科自2007年4月～2009年4月開展單藥吉西他濱聯(lián)合三維適形放療治療和護(hù)理老年晚期非小細(xì)胞肺癌患者64例，療效滿意，現(xiàn)報(bào)告如下。
1 資料與方法
1.1 一般資料 本組共64例,男性41例,女性23例,年齡67～79歲,平均73歲，Karnofsky評分均≥70分,經(jīng)病理或細(xì)胞學(xué)確診,鱗癌44例,腺癌20例。TNM分期:Ⅲa期16例，Ⅲb期36例,Ⅳ期12例;初治者44例，復(fù)治者20例。合并癥依次為冠心病、高血壓、慢性支氣管炎及肺炎、糖尿病等。治療前經(jīng)血常規(guī)、心、肝、腎功能檢查均正常。所有病例均有可測量病灶,復(fù)治者近1個(gè)月內(nèi)未接受過化療和放療。預(yù)計(jì)生存期超過3個(gè)月。
