摘要
目的分析以营养干预为导向的前瞻性护理对化疗联合双硫仑治疗的晚期乳腺癌患者的影响。方法本研究为随机对照试验。前瞻性选取2019年6月至2022年5月河南大学第一附属医院80例晚期乳腺癌患者,均接受化疗联合双硫仑治疗,根据随机数字表法分为两组,每组40例。对照组年龄(52.16±8.27)岁,病理类型:浸润性导管癌36例、浸润性小叶癌4例,月经状态:绝经16例、未绝经24例,分子亚型:Luminal型23例、三阴性13例、人表皮生长因子受体-2(Her-2)过表达型4例,接受常规护理干预。观察组年龄(53.05±7.29)岁,病理类型:浸润性导管癌34例、浸润性小叶癌6例,月经状态:绝经18例、未绝经22例,分子亚型:Luminal型22例、三阴性15例、Her-2过表达型3例,在对照组基础上接受以营养干预为导向的前瞻性护理干预。比较两组营养状态、干预前后免疫功能[外周血免疫球蛋白A(immunoglobulin A,IgA)、IgM、IgG,T淋巴细胞亚群(CD3+、CD4+、CD4+/CD8+)]、生活质量[乳腺癌患者生存质量量表(FACT-B)]。统计学方法采用χ^(2)检验、t检验、u检验。结果观察组营养良好率高于对照组[70.00%(28/40)比55.00%(22/40)](u=2.240,P<0.05);干预后,观察组CD3+、CD4+、CD4+/CD8+、血清IgA、IgM、IgG水平均高于对照组[(50.12±3.88)比(39.76±4.04)、(37.22±3.51)比(30.64±2.99)、(1.41±0.15)比(1.29±0.18)、(2.14±0.31)g/L比(1.85±0.27)g/L、(1.94±0.33)g/L比(1.36±0.28)g/L、(11.62±3.50)g/L比(10.07±2.84)g/L],差异均有统计学意义(t=11.697、9.026、3.239、4.462、8.476、2.175,均P<0.05);干预后,观察组情感状况、生理状况、功能状况、社会家庭状况、附加关注评分均高于对照组[(20.15±3.07)分比(16.14±2.58)分、(22.13±3.85)分比(17.69±3.24)分、(22.64±3.59)分比(17.83±3.12)分、(20.36±4.58)分比(17.14±4.09)分、(27.12±7.39)分比(20.45±6.80)分],差异均有统计学意义(t=6.324、5.581、6.396、3.317、4.201,均P<0.05)。结论以营养干预为导向的前瞻性护理应用于化疗联合双硫仑治疗的晚期乳腺癌患者,可改善其营养状态、免疫功能,提高生活质量。
Objective To analyze the effect of nutrition intervention-oriented prospective nursing for patients with advanced breast cancer treated by chemotherapy combined with disulfiram.Methods This study was a randomized controlled trial.A total of 80 patients with advanced breast cancer who received chemotherapy combined with disulfiram in The First Affiliated Hospital of Henan University from June 2019 to May 2022 were prospectively selected and were divided into two groups according to the random number table method.The control group was(52.16±8.27)years old;the pathological types included 36 cases of invasive ductal carcinoma and 4 cases of invasive lobular carcinoma;there were 16 cases of menopause and 24 cases of premenopause;the molecular subtypes included 23 cases of Luminal type,13 cases of triple-negative type,and 4 cases of human epidermal growth factor receptor-2(Her-2)overexpression type.The observation group was(53.05±7.29)years old;the pathological types included 34 cases of invasive ductal carcinoma and 6 cases of invasive lobular carcinoma;there were 18 cases of menopause and 22 cases of premenopause;the molecular subtypes included 22 cases of Luminal type,15 cases of triple-negative type,and 3 cases of Her-2 overexpression type.The control group received routine nursing intervention,and the observation group received nutrition intervention-oriented prospective nursing intervention on the basis of the control group.The two groups were compared in terms of nutritional status and immune function[peripheral blood immunoglobulin A(IgA),IgM,IgG,and T-lymphocyte subsets(CD3+,CD4+,and CD4+/CD8+)]and quality of life[Functional Assessment of Cancer Therapy-Breast(FACT-B)]before and after intervention.Statistical methods used wereχ^(2) test,t test,and u test.Results The rate of good nutrition in the observation group was higher than that in the control group[70.00%(28/40)vs.55.00%(22/40)](u=2.240,P<0.05).After intervention,the levels of CD3+,CD4+,CD4+/CD8+,and serum IgA,IgM,and IgG in the observation group were higher than those in the control group[(50.12±3.88)vs.(39.76±4.04),(37.22±3.51)vs.(30.64±2.99),(1.41±0.15)vs.(1.29±0.18),(2.14±0.31)g/L vs.(1.85±0.27)g/L,(1.94±0.33)g/L vs.(1.36±0.28)g/L,(11.62±3.50)g/L vs.(10.07±2.84)g/L],with statistically significant differences(t=11.697,9.026,3.239,4.462,8.476,and 2.175;all P<0.05).After intervention,the scores of emotional status,physiological status,functional status,social and family status,and additional attention in the observation group were higher than those in the control group[(20.15±3.07)points vs.(16.14±2.58)points,(22.13±3.85)points vs.(17.69±3.24)points,(22.64±3.59)points vs.(17.83±3.12)points,(20.36±4.58)points vs.(17.14±4.09)points,(27.12±7.39)points vs.(20.45±6.80)points],with statistically significant differences(t=6.324,5.581,6.396,3.317,and 4.201;all P<0.05).Conclusion Nutrition intervention-oriented prospective nursing can improve the nutritional status,immune function,and quality of life in patients with advanced breast cancer treated by chemotherapy combined with disulfiram.
作者
田瑞婷
何建鑫
Tian Ruiting;He Jianxin(Ward 2,Breast and Thyroid Surgery,The First Affiliated Hospital of Henan University,Kaifeng 475004,China)
出处
《国际医药卫生导报》
2023年第11期1599-1603,共5页
International Medicine and Health Guidance News
基金
河南省医学科技攻关计划(联合共建)项目(LHGJ20190514)。
关键词
晚期乳腺癌
化疗
双硫仑
免疫功能
营养
前瞻性护理
Advanced breast cancer
Chemotherapy
Disulfiram
Immune function
Nutrition
Prospective nursing
