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构建循环护理体系对小细胞肺癌经PICC化疗期间并发症的影响研究

2015-01-10 MedSci MedSci原创

肺癌是目前世界上发病率以及病死率最高的恶性肿瘤,手术结合放化疗的传统治疗方法难以达到满意效果,而晚期小细胞肺癌的临床治疗效果更差。小细胞肺癌约占肺癌的1/4,其生物学行为与非小细胞肺癌明显不同,临床过程和疾病的自然病程明显快于非小细胞肺癌。 近日,江苏省肿瘤医院113病区研究人员发表论文,旨在探讨循环护理体系在小细胞肺癌患者经PICC化疗期间的临床护理效果。研究指出,循环护理体系可有效提升护

肺癌是目前世界上发病率以及病死率最高的恶性肿瘤,手术结合放化疗的传统治疗方法难以达到满意效果,而晚期小细胞肺癌的临床治疗效果更差。小细胞肺癌约占肺癌的1/4,其生物学行为与非小细胞肺癌明显不同,临床过程和疾病的自然病程明显快于非小细胞肺癌。

近日,江苏省肿瘤医院113病区研究人员发表论文,旨在探讨循环护理体系在小细胞肺癌患者经PICC化疗期间的临床护理效果。研究指出,循环护理体系可有效提升护理质量,降低置管并发症的发生率,提高患者满意度。该文发表在2014年第17期《社区医学杂志》上。

选取2012年6月—2014年6月肿瘤科收治的小细胞肺癌患者100例。按照随机数字表法分为观察组和对照组各50例,对照组实施常规护理干预,观察组实施循环护理体系,通过比较PICC置管相关并发症的发生率、导管留置时间、患者对护理服务的满意度进行效果评价。计量资料采用t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。

观察组并发症的发生率为14.00%(7/50),对照组为36.00%(18/50),两组比较差异有统计学意义(P<0.05)。观察组导管留置时间、对护理服务的满意度评分分别为(138.14±16.37)d、(97.89±2.64)分,对照组分别为(113.57±17.47)d、(83.36±1.72)分,两组比较差异均有统计学意义(均P<0.05)。

MedSci点评:
这不是标准的随机对照研究(RCT),不符合随机对照研究的报告规范CONSORT规范(见:RCT临床研究遵循CONSORT规范(中文版))。同时主要研究的终点为并发症,但没有对并发症进行定义,例如置管感染的发生,静脉血栓的发生,还是置管移位等,需要区别报道,而不能仅仅笼统说并发症发生率。当然,这篇研究选择小细胞肺癌,具有相当大的挑战。因为小细胞肺癌的治疗相对不太统一,患者治疗过程中脱失率较高,甚至部分患者合适放疗。象本研究中没有报道这些脱失状况,是非常不合理的。

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  1. [GetPortalCommentsPageByObjectIdResponse(id=211808, encodeId=059b211808cb, content=点评相当到位, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJ4C63YIgibXLuQxVdA6LKwEfZFPxYyMf2oASjNP6xVSSU5zVvB0luGCTrxf18ZVeBibgpxjZn0jKWg/132, createdBy=2de11730243, createdName=1dee73b8m97(暂无匿称), createdTime=Sat Jun 17 07:37:20 CST 2017, time=2017-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=27004, encodeId=72202e004e7, content=点评是亮点, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=761999770, createdName=wingjoy2009, createdTime=Thu Jun 11 14:31:00 CST 2015, time=2015-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=26248, encodeId=0d4126248b9, content=小编评论很客观, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=761999770, createdName=wingjoy2009, createdTime=Mon Jun 08 07:33:00 CST 2015, time=2015-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1757643, encodeId=a3671e57643b9, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Thu Oct 29 20:38:00 CST 2015, time=2015-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=15307, encodeId=f9591530ec4, content=学习了,谢谢!, beContent=null, objectType=article, channel=null, level=null, likeNumber=140, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b5a81612548, createdName=xjtumd07, createdTime=Mon Feb 09 09:46:00 CST 2015, time=2015-02-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1414550, encodeId=0777141455093, content=<a href='/topic/show?id=7c2b142565d' target=_blank style='color:#2F92EE;'>#PICC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14256, encryptionId=7c2b142565d, topicName=PICC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2c6b3060279, createdName=tomyang87, createdTime=Mon Jan 12 11:38:00 CST 2015, time=2015-01-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1461994, encodeId=214c146199412, content=<a href='/topic/show?id=32fd933505' target=_blank style='color:#2F92EE;'>#ICC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9335, encryptionId=32fd933505, topicName=ICC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=docwu2019, createdTime=Mon Jan 12 11:38:00 CST 2015, time=2015-01-12, status=1, ipAttribution=)]
    2017-06-17 1dee73b8m97(暂无匿称)

    点评相当到位

    0

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    2015-06-11 wingjoy2009

    点评是亮点

    0

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    2015-06-08 wingjoy2009

    小编评论很客观

    0

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    2015-10-29 丁鹏鹏
  5. [GetPortalCommentsPageByObjectIdResponse(id=211808, encodeId=059b211808cb, content=点评相当到位, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJ4C63YIgibXLuQxVdA6LKwEfZFPxYyMf2oASjNP6xVSSU5zVvB0luGCTrxf18ZVeBibgpxjZn0jKWg/132, createdBy=2de11730243, createdName=1dee73b8m97(暂无匿称), createdTime=Sat Jun 17 07:37:20 CST 2017, time=2017-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=27004, encodeId=72202e004e7, content=点评是亮点, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=761999770, createdName=wingjoy2009, createdTime=Thu Jun 11 14:31:00 CST 2015, time=2015-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=26248, encodeId=0d4126248b9, content=小编评论很客观, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=761999770, createdName=wingjoy2009, createdTime=Mon Jun 08 07:33:00 CST 2015, time=2015-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1757643, encodeId=a3671e57643b9, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Thu Oct 29 20:38:00 CST 2015, time=2015-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=15307, encodeId=f9591530ec4, content=学习了,谢谢!, beContent=null, objectType=article, channel=null, level=null, likeNumber=140, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b5a81612548, createdName=xjtumd07, createdTime=Mon Feb 09 09:46:00 CST 2015, time=2015-02-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1414550, encodeId=0777141455093, content=<a href='/topic/show?id=7c2b142565d' target=_blank style='color:#2F92EE;'>#PICC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14256, encryptionId=7c2b142565d, topicName=PICC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2c6b3060279, createdName=tomyang87, createdTime=Mon Jan 12 11:38:00 CST 2015, time=2015-01-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1461994, encodeId=214c146199412, content=<a href='/topic/show?id=32fd933505' target=_blank style='color:#2F92EE;'>#ICC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9335, encryptionId=32fd933505, topicName=ICC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=docwu2019, createdTime=Mon Jan 12 11:38:00 CST 2015, time=2015-01-12, status=1, ipAttribution=)]
    2015-02-09 xjtumd07

    学习了,谢谢!

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=211808, encodeId=059b211808cb, content=点评相当到位, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJ4C63YIgibXLuQxVdA6LKwEfZFPxYyMf2oASjNP6xVSSU5zVvB0luGCTrxf18ZVeBibgpxjZn0jKWg/132, createdBy=2de11730243, createdName=1dee73b8m97(暂无匿称), createdTime=Sat Jun 17 07:37:20 CST 2017, time=2017-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=27004, encodeId=72202e004e7, content=点评是亮点, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=761999770, createdName=wingjoy2009, createdTime=Thu Jun 11 14:31:00 CST 2015, time=2015-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=26248, encodeId=0d4126248b9, content=小编评论很客观, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=761999770, createdName=wingjoy2009, createdTime=Mon Jun 08 07:33:00 CST 2015, time=2015-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1757643, encodeId=a3671e57643b9, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Thu Oct 29 20:38:00 CST 2015, time=2015-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=15307, encodeId=f9591530ec4, content=学习了,谢谢!, beContent=null, objectType=article, channel=null, level=null, likeNumber=140, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b5a81612548, createdName=xjtumd07, createdTime=Mon Feb 09 09:46:00 CST 2015, time=2015-02-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1414550, encodeId=0777141455093, content=<a href='/topic/show?id=7c2b142565d' target=_blank style='color:#2F92EE;'>#PICC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14256, encryptionId=7c2b142565d, topicName=PICC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2c6b3060279, createdName=tomyang87, createdTime=Mon Jan 12 11:38:00 CST 2015, time=2015-01-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1461994, encodeId=214c146199412, content=<a href='/topic/show?id=32fd933505' target=_blank style='color:#2F92EE;'>#ICC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9335, encryptionId=32fd933505, topicName=ICC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=docwu2019, createdTime=Mon Jan 12 11:38:00 CST 2015, time=2015-01-12, status=1, ipAttribution=)]
    2015-01-12 tomyang87
  7. [GetPortalCommentsPageByObjectIdResponse(id=211808, encodeId=059b211808cb, content=点评相当到位, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJ4C63YIgibXLuQxVdA6LKwEfZFPxYyMf2oASjNP6xVSSU5zVvB0luGCTrxf18ZVeBibgpxjZn0jKWg/132, createdBy=2de11730243, createdName=1dee73b8m97(暂无匿称), createdTime=Sat Jun 17 07:37:20 CST 2017, time=2017-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=27004, encodeId=72202e004e7, content=点评是亮点, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=761999770, createdName=wingjoy2009, createdTime=Thu Jun 11 14:31:00 CST 2015, time=2015-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=26248, encodeId=0d4126248b9, content=小编评论很客观, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=761999770, createdName=wingjoy2009, createdTime=Mon Jun 08 07:33:00 CST 2015, time=2015-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1757643, encodeId=a3671e57643b9, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Thu Oct 29 20:38:00 CST 2015, time=2015-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=15307, encodeId=f9591530ec4, content=学习了,谢谢!, beContent=null, objectType=article, channel=null, level=null, likeNumber=140, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b5a81612548, createdName=xjtumd07, createdTime=Mon Feb 09 09:46:00 CST 2015, time=2015-02-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1414550, encodeId=0777141455093, content=<a href='/topic/show?id=7c2b142565d' target=_blank style='color:#2F92EE;'>#PICC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14256, encryptionId=7c2b142565d, topicName=PICC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2c6b3060279, createdName=tomyang87, createdTime=Mon Jan 12 11:38:00 CST 2015, time=2015-01-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1461994, encodeId=214c146199412, content=<a href='/topic/show?id=32fd933505' target=_blank style='color:#2F92EE;'>#ICC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9335, encryptionId=32fd933505, topicName=ICC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=docwu2019, createdTime=Mon Jan 12 11:38:00 CST 2015, time=2015-01-12, status=1, ipAttribution=)]
    2015-01-12 docwu2019

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