优化护理策略在提高肾癌靶向治疗的效果及降低不良反应中的作用

吴丹+曾丽娟

【摘要】 目的：評价应用优化护理策略在提高肾癌靶向治疗的效果及对不良反应的影响。方法：选择2013年1月-2015年1月于本院进行肾癌靶向治疗的患者56例，将其按照随机数字表法分为试验组和对照组，各28例，在靶向治疗的基础上分别采用优化护理策略和常规护理模式，定期随访24个月以上，比较两组临床治疗效果、患者1年和2年总体生存率及无进展生存率、总体生存期和无进展生存期、Ⅲ级以上不良反应、治疗依从性、焦虑、抑郁状态和生活质量等。结果：试验组的ORR和CR分别为78.57%（22/28）和53.57%（15/28），显著高于对照组的42.86%（12/28）和25.00%（7/28）（P<0.05）；试验组的OS为（20.6±6.3）个月，PFS为（10.9±2.6）个月，明显高于对照组的（15.3±5.7）个月和（8.1±2.1）个月（P<0.05）；试验组Ⅲ级以上不良反应发生率显著低于对照组（P<0.05）；治疗依从性，焦虑、抑郁状态和生活质量的改善程度均显著高于对照组，比较差异均有统计学意义（P<0.05）。结论：与传统护理模式相比，在肾癌靶向治疗中应用优化护理策略，可以明显提高临床疗效，显著改善患者的生存预期，降低不良反应发生风险，提高患者的生活质量，值得推广。

【关键词】 肾癌； 疗效； 不良反应； 优化护理策略； 靶向治疗

【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