手足低温法预防盐酸多柔比星脂质体致手足综合征的效果

doi:10.3969/j.issn.1004-583X.2024.06.009

摘要/Abstract

摘要：

目的从临床角度探究局部冷敷法在盐酸多柔比星脂质体(PLD)致相关手足综合征(HFS)中的应用效果。方法采取非同期随机对照试验,选取2021年6月至2023年6月河北工程大学附属医院乳腺外科已治疗的乳腺癌患者为研究对象,以2021年6月至2022年5月化疗的乳腺癌患者为常规护理组(n=58),2022年6月至2023年6月化疗的乳腺癌患者为局部冷敷法组(n=55)。比较两组在4次PLD化疗阶段HFS的发生率、患者治疗依从性、诊疗满意度及患者就医体验感。结果局部冷敷法组HFS发生率为23.6%(13/55),常规护理组为44.8%(26/58);局部冷敷法组HFS发生率低于常规护理组(χ²=5.609,P=0.018)。局部冷敷法组HFS严重程度轻于对照组 (P<0.05)。局部冷敷法组Ⅱ级及以上HFS发生率为10.9%、常规护理组为25.9%;局部冷敷法组Ⅱ级及以上HFS发生率低于常规护理组(P<0.05)。局部冷敷法组治疗依从性及满意度均高于常规护理组(P<0.05)。结论局部冷敷法可有效预防和降低PLD化疗过程中HFS的发生率和严重程度、提高患者护理干预的依从性、患者满意度较高。

关键词: 手足口病, 局部冷敷, 乳腺癌, 盐酸多柔比星脂质体

Abstract:

Objective To observe the application effect of local cold compress in pegylated liposomal doxorubicin(PLD)induced hand-foot syndrome(HFS)from a clinical perspective. Methods During June 2021 to June 2023, a non-synchronous randomized controlled trial was conducted to recruit breast cancer(BC) patients who received chemotherapy with a PLD in the Department of Breast Surgery, Affiliated Hospital of Hebei Engineering University as the research objects, they were randomized to the routine care group (from June 2021 to May 2022, n=58) or local cold compress group (from June 2022 to June 2023, n=55). The incidence of HFS, treatment compliance, satisfaction and medical experience of the patients were included as comparisons between groups. Results The incidence of HFS in the local cold compress group was significantly lower than that of the routine care group (23.6% [13/55] vs 44.8% [26/58], χ²=5.609, P=0.018). The severity of HFS in the local cold compress group was significantly lighter than that of the routine care group (P<0.05). The incidence of HFS of grade II and above in the local cold compress group was significantly lower than that of the routine care group (10.9% vs 25.9%, P<0.05). The treatment compliance and satisfaction of patients in the local cold compress group were significantly higher than those of the routine care group (P<0.05).Conclusion Local cold compress can effectively prevent the incidence and reduce and severity of HFS in chemotherapy with a PLD,and it is capable of improving the treatment compliance and satisfaction of patients.

Key words: hand, foot and mouth disease, local cold compress, breast cancer, pegylated liposomal doxorubicin

中图分类号:

R758.25

史素芳, 贾东晓, 韩建军, 赵红祥, 任雁飞, 李俊娇. 手足低温法预防盐酸多柔比星脂质体致手足综合征的效果[J]. 临床荟萃, 2024, 39(6): 537-541.

Shi Sufang, Jia Dongxiao, Han Jianjun, Zhao Hongxiang, Ren Yanfei, Li Junjiao. Effect of local cold compress in the prevention of pegylated liposomal doxorubicin induced hand-foot syndrome[J]. Clinical Focus, 2024, 39(6): 537-541.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2024.06.009

https://huicui.hebmu.edu.cn/CN/Y2024/V39/I6/537

图/表 6

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项目	常规护理组 (n=58)	局部冷敷法组 (n=55)	χ²值	P值
月经情况
未绝经绝经	38(65.5) 20(34.5)	36(65.5) 19(34.5)	<0.01	0.994
组织学分级
1	1(1.7)	3(5.5)
2	53(91.4)	47(85.5)	1.392	-0.498
3	4(6.9)	5(9.1)
T分期
T1	22(37.9)	16(29.1)
T2	29(50.0)	26(47.3)	2.900	0.407
T3	5(8.6)	10(18.2)
T4	2(3.4)	3(5.5)
N分期
N0	29(50.0)	33(60.0)
N1	20(34.5)	15(27.3)	1.144	0.565
N2	9(15.5)	7(12.7)
TNM分期
1期	16(27.6)	15(27.3)
2期	28(48.3)	28(50.9)	0.107	0.948
3期	14(24.1)	12(21.8)

项目	常规护理组 (n=58)	局部冷敷法组 (n=55)	χ²值	P值
月经情况
未绝经绝经	38(65.5) 20(34.5)	36(65.5) 19(34.5)	<0.01	0.994
组织学分级
1	1(1.7)	3(5.5)
2	53(91.4)	47(85.5)	1.392	-0.498
3	4(6.9)	5(9.1)
T分期
T1	22(37.9)	16(29.1)
T2	29(50.0)	26(47.3)	2.900	0.407
T3	5(8.6)	10(18.2)
T4	2(3.4)	3(5.5)
N分期
N0	29(50.0)	33(60.0)
N1	20(34.5)	15(27.3)	1.144	0.565
N2	9(15.5)	7(12.7)
TNM分期
1期	16(27.6)	15(27.3)
2期	28(48.3)	28(50.9)	0.107	0.948
3期	14(24.1)	12(21.8)

组别	例数	0级	Ⅰ级	Ⅱ级	Ⅲ级
常规护理组	58	32(55.2)	11(19.0)	10(17.2)	5(8.6)
局部冷敷法组	55	42(76.4)	7(12.7)	4(7.3)	2(3.6)
Z值		2.432
P值		0.015

组别	例数	0级	Ⅰ级	Ⅱ级	Ⅲ级
常规护理组	58	32(55.2)	11(19.0)	10(17.2)	5(8.6)
局部冷敷法组	55	42(76.4)	7(12.7)	4(7.3)	2(3.6)
Z值		2.432
P值		0.015

组别	例数	差	良好
常规护理组	58	19(32.8)	39(67.2)
局部冷敷法组	55	6(10.9)	49(89.1)
χ²值		7.822
P值		0.005