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宫颈鳞癌同期放化疗后放射性肠炎危险因素及综合措施 研究
周超,朱莺,徐德静,桓建英
江苏省肿瘤医院,江苏省肿瘤防治研究所,南京医科大学附属肿瘤医院放疗科, 南京210009
Study on risk factors and comprehensive measures of radiation enteritis after concurrent radiotherapy and chemotherapy for cervical squamous cell carcinoma
Zhou Chao, Zhu Ying, Xu Dejing, Huan Jianying
Radiation Department, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing 210009, Jiangsu, China
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摘要 目的探究恶性肿瘤宫颈鳞癌患者同期放化疗发生放射性肠炎的危险因素及综合措施效果。方法选取南京医科大学附 属肿瘤医院2019年1月至2021年3月接诊并实施根治性切除术治疗的宫颈鳞癌患者500例,依据同期放化疗发生放射性肠炎情况分 为放射性肠炎组与对照组,多因素Logistic回归分析确定宫颈鳞癌患者同期放化疗发生放射性肠炎的影响因素。对放射性肠炎组患 者实施个性化膀胱充盈训练、中药保留灌肠护理、合理化制定放疗方案、心理护理以及健康宣教等护理干预。计算放射性肠炎组患者 的护理临床疗效,对比放射性肠炎患者护理干预前后症状严重程度≥2级的比例差异。结果225例发生放射性肠炎,发生率为45%。 多因素Logistic回归分析发现宫颈鳞癌患者年龄≥60岁(OR=7.253,95%CI=3.294~15.970)、肿瘤Ⅲ期(OR=38.705,95%CI=12.546~ 119.410)、肿瘤直径≥4 cm(OR=11.669,95%CI=4.868~27.970)和平均放疗受照剂量≥60 Gy(OR=40.223,95%CI=14.460~111.883)因 素是同期放化疗发生放射性肠炎的危险因素,营养良好(OR=2.474,95%CI=1.108~5.527)是患者发生放射性肠炎的保护因素。225 例放射性肠炎患者干预后的疗效为94.67%。相比于干预前,225例放射性肠炎患者干预后的≥2级症状严重程度比例明显降低,分别 为69.33%、32.00%(P<0.05)。结论年龄≥60岁、肿瘤Ⅲ期、肿瘤直径≥4 cm、平均放疗受照剂量≥60 Gy因素是宫颈鳞癌患者同期放化 疗发生放射性肠炎的危险因素,营养良好是保护因素,应针对存在以上危险因素的患者进行重点预防干预。
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周超
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桓建英
关键词 宫颈鳞癌放射性肠炎危险因素护理    
Abstract:Objective To explore the risk factors and therapeutic effects of concurrent radiotherapy and chemotherapy in patients with cervical squamous cell carcinoma. Method A total of 500 patients with cervical squamous cell carcinoma treated and treated with radical resection in Nanjing Medical University Cancer Hospital from January 2019 to March 2021 were selected. According to the occurrence of radiation enteritis during the same period of radiotherapy and chemotherapy, they were divided into radiation enteritis group and control group. Multivariable Logistic regression analysis were used to determine the influence factors of concurrent chemoradiation radioactive enteritis of the cervical squamous carcinoma patients during the same period. The patients in the radiation enteritis group were given personalized bladder filling training, traditional Chinese medicine retention enema nursing, rational radiotherapy program, psychological nursing and health education and other nursing interventions. To calculate the nursing clinical efficacy of patients with radiation enteritis, and to compare the proportion of patients with radiation enteritis symptom severity≥2 grade before and after nursing intervention. Result 225 cases had radiation enteritis, and the incidence rate was 45%. Multivariate Logistic regression analysis showed that≥60 years old (OR=7.253, 95%CI=3.294-15.970), stage Ⅲ tumor (OR=38.705, 95%CI=12.546-119.410), tumor diameter≥4 cm (OR=11.669, 95%CI=4.868-27.970), average radiation dose≥60 Gy (OR=40.223, 95%CI=14.460-111.883) were risk factors for the occurrence of radiation enteritis during concurrent radiotherapy and chemotherapy, and good nutrition (OR=2.474, 95%CI=1.108-5.527) was a protective factor for the occurrence of radiation enteritis. The therapeutic effect of radiation enteritis in 225 patients was 94.67%. Compared with before intervention, the proportion of symptom severity≥2 grade in 225 patients with radiation enteritis significantly decreased after intervention, 69.33% and 32.00% (P<0.05). Conclusion Age≥60 years, tumor stage Ⅲ, tumor diameter≥4 cm, average radiation dose≥60 Gy are the risk factors for the occurrence of radiation enteritis in patients with cervical squamous cell carcinoma during concurrent radiotherapy and chemotherapy. Good nutrition is a protective factor, and the patients with the above risk factors should be targeted for prevention and intervention.
Key wordsCervical squamous cell carcinoma    Radiation enteritis    Hazard factor    Nursing
收稿日期: 2021-08-23     
基金资助:江苏省妇幼健康科研项目(F201870)
通讯作者: 朱莺,电子邮箱:2470708602@qq.com   
引用本文:   
周超,朱莺,徐德静,桓建英. 宫颈鳞癌同期放化疗后放射性肠炎危险因素及综合措施 研究[J]. 肿瘤代谢与营养电子杂志, 2022, 9(2): 241-246.
Zhou Chao, Zhu Ying, Xu Dejing, Huan Jianying. Study on risk factors and comprehensive measures of radiation enteritis after concurrent radiotherapy and chemotherapy for cervical squamous cell carcinoma. Electron J Metab Nutr Cancer, 2022, 9(2): 241-246.