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医学论文范文:吉西他滨同步三维适形放疗治疗老年晚期非小细胞肺癌的护理
【摘要】 目的 总结吉西他滨同步三维适形放疗治疗老年晚期非小细胞肺癌的护理经验。方法 64例老年晚期非小细胞肺癌在三维适形放疗1周后,用吉西他滨0.8～1 g/m2 静脉滴注,在放疗第1天、8天、15天、22天以周剂量方式进行治疗。用肿瘤治疗毒性反应评分标准进行观察评估,并给予医疗护理干预。结果 64例患者中发生不同程度毒性反应,白细胞减少、血小板下降、恶心、呕吐,放射性肺炎、食管炎等发生率较高,但均完成治疗计划。结论 做好心理护理、预防感染、毒性反应观察与护理是控制和减少毒性反应发生的必要手段,可以保证治疗方案顺利进行。
【关键词】 吉西他滨;非小细胞肺癌;适形放疗;护理
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医学全.在线www.med126.com.
Key words:gemcitabine; nonsmall cell lung cancer; conformal radiotherapy; nursing
非小细胞肺癌(NSCLC)是常见恶性肿瘤之一,50%以上肺癌患者诊断时年龄超过65岁,约1/3年龄大于70岁，就诊时绝大多数患者因病情已属晚期、一般状况差及并发症较多等原因失去手术机会而采用以放、化疗为主的综合治疗。含铂类的联合化疗被认为是有效的治疗，但多数70岁以上的老年晚期非小细胞肺癌患者心、肝、肾等重要脏器的生理功能相对低下，对联合化疗的耐受性较差。我科自2007年4月～2009年4月开展单药吉西他滨联合三维适形放疗治疗和护理老年晚期非小细胞肺癌患者64例，疗效满意，现报告如下。
1 资料与方法
1.1 一般资料 本组共64例,男性41例,女性23例,年龄67～79岁,平均73岁，Karnofsky评分均≥70分,经病理或细胞学确诊,鳞癌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，复治者20例。合并症依次为冠心病、高血压、慢性支气管炎及肺炎、糖尿病等。治疗前经血常规、心、肝、肾功能检查均正常。所有病例均有可测量病灶,复治者近1个月内未接受过化疗和放疗。预计生存期超过3个月。
