吳丹+曾麗娟

【摘要】 目的：評(píng)價(jià)應(yīng)用優(yōu)化護(hù)理策略在提高腎癌靶向治療的效果及對不良反應(yīng)的影響。方法：選擇2013年1月-2015年1月于本院進(jìn)行腎癌靶向治療的患者56例，將其按照隨機(jī)數(shù)字表法分為試驗(yàn)組和對照組，各28例，在靶向治療的基礎(chǔ)上分別采用優(yōu)化護(hù)理策略和常規(guī)護(hù)理模式，定期隨訪24個(gè)月以上，比較兩組臨床治療效果、患者1年和2年總體生存率及無進(jìn)展生存率、總體生存期和無進(jìn)展生存期、Ⅲ級(jí)以上不良反應(yīng)、治療依從性、焦慮、抑郁狀態(tài)和生活質(zhì)量等。結(jié)果：試驗(yàn)組的ORR和CR分別為78.57%（22/28）和53.57%（15/28），顯著高于對照組的42.86%（12/28）和25.00%（7/28）（P<0.05）；試驗(yàn)組的OS為（20.6±6.3）個(gè)月，PFS為（10.9±2.6）個(gè)月，明顯高于對照組的（15.3±5.7）個(gè)月和（8.1±2.1）個(gè)月（P<0.05）；試驗(yàn)組Ⅲ級(jí)以上不良反應(yīng)發(fā)生率顯著低于對照組（P<0.05）；治療依從性，焦慮、抑郁狀態(tài)和生活質(zhì)量的改善程度均顯著高于對照組，比較差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論：與傳統(tǒng)護(hù)理模式相比，在腎癌靶向治療中應(yīng)用優(yōu)化護(hù)理策略，可以明顯提高臨床療效，顯著改善患者的生存預(yù)期，降低不良反應(yīng)發(fā)生風(fēng)險(xiǎn)，提高患者的生活質(zhì)量，值得推廣。

【關(guān)鍵詞】 腎癌； 療效； 不良反應(yīng)； 優(yōu)化護(hù)理策略； 靶向治療

【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