優化護理策略在提高腎癌靶向治療的效果及降低不良反應中的作用

吳丹+曾麗娟

【摘要】 目的：評價應用優化護理策略在提高腎癌靶向治療的效果及對不良反應的影響。方法：選擇2013年1月-2015年1月于本院進行腎癌靶向治療的患者56例，將其按照隨機數字表法分為試驗組和對照組，各28例，在靶向治療的基礎上分別采用優化護理策略和常規護理模式，定期隨訪24個月以上，比較兩組臨床治療效果、患者1年和2年總體生存率及無進展生存率、總體生存期和無進展生存期、Ⅲ級以上不良反應、治療依從性、焦慮、抑郁狀態和生活質量等。結果：試驗組的ORR和CR分別為78.57%（22/28）和53.57%（15/28），顯著高于對照組的42.86%（12/28）和25.00%（7/28）（P<0.05）；試驗組的OS為（20.6±6.3）個月，PFS為（10.9±2.6）個月，明顯高于對照組的（15.3±5.7）個月和（8.1±2.1）個月（P<0.05）；試驗組Ⅲ級以上不良反應發生率顯著低于對照組（P<0.05）；治療依從性，焦慮、抑郁狀態和生活質量的改善程度均顯著高于對照組，比較差異均有統計學意義（P<0.05）。結論：與傳統護理模式相比，在腎癌靶向治療中應用優化護理策略，可以明顯提高臨床療效，顯著改善患者的生存預期，降低不良反應發生風險，提高患者的生活質量，值得推廣。

【關鍵詞】 腎癌； 療效； 不良反應； 優化護理策略； 靶向治療

【Abstract】 Objective：To observe the efficacy of optimized nursing strategy to improving the curative effect and reducing the adverse reaction risk in the targeted therapy of renal cell carcinoma. Method：From January 2013 to January 2015，56 patients with renal cancer targeted therapy in our hospital were selected，they were randomly divided into the experimental group and the control group，28 cases in each group. The optimized nursing strategy and routine nursing mode were adopted on the basis of targeted therapy respectively，all patients were followed-up at least 24 months.The curative effect，1 year and 2 years overall survival rate，and progression-free survival rate，overall survival and progression-free survival， above Ⅲ adverse reaction，therapeutic compliance and quality of life of two groups were comparatively analyzed.Result：ORR and CR of the experimental group were 78.57%（22/28）and 53.57%（15/28），which were significantly higher than 42.86%（12/28） and 25.00%（7/28） of the control group（P<0.05），OS and PFS of the experimental group were（20.6±6.3）months and（10.9±2.6）months，which were much higher than （15.3±5.7）months and（8.1±2.1）months of the control group（P<0.05），the adverse reaction above Ⅲ of the experimental group were significantly lower than those of the control group（P<0.05），the improvement of anxiety and depression status，therapeutic compliance and quality of life of the experimental group were significantly higher than those of the control group（P<0.05）.Conclusion：Comparing with routine nursing mode，the optimized nursing strategy can obviously improve enhance the curative effect of targeted therapy in renal cell carcinoma，and it also can significantly improve the survival expectancy，reduce adverse reaction risk，improve the quality of life for patients，is worth promoting.

【Key words】 Renal cell carcinoma； Curative effect； Adverse reaction； Optimized nursing strategy；Targeted therapyendprint