Department of Clinical Laboratory, Yantaishan Hospital, Yantai 264000, Shandong, China.
Department of Neurology (I), Affiliated Qingdao Central Hospital, Qingdao University, Qingdao 266042, Shandong, China.
J Healthc Eng. 2022 Jan 25;2022:8335400. doi: 10.1155/2022/8335400. eCollection 2022.
The purpose of this study is to explore the clinical value of high-quality nursing in concurrent radiotherapy and chemotherapy after glioma surgery and its influence on the stress indicators such as cortisol (Cor), adrenocorticotrophic hormone (ACTH), and C-reactive protein (CRP).
A total of 94 glioma patients diagnosed and treated in our hospital were randomly divided into a research group and a control group, with 47 cases in each group. Both groups of patients were given concurrent radiotherapy and chemotherapy. On this basis, patients in the control group were given basic care, while patients in the research group were given a combination of basic care and high-quality care. The nursing satisfaction and adverse reactions of the two groups were compared. The pain degree and the levels of stress indicators Cor, ACTH, and CRP at different time points were compared between the two groups. The sleep quality, bad mood, and quality of life before and after nursing were compared between the two groups.
After nursing, the nursing satisfaction of the research group (95.74%) was higher than that of the control group (80.85%), and the difference between the two groups was statistically significant ( = 11.678, < 0.05). There was no significant difference between patients in the Visual Analogue Scale (VAS) score and the levels of stress indicators Cor, ACTH, and CRP at the T1 time point between the two groups ( > 0.05). With the passage of time, the levels of Cor and ACTH of the two groups showed an upward trend. At T4, the increased levels of Cor and ACTH in the research group were less than those in the control group, and the difference was statistically significant ( < 0.05). The VAS scores and CRP levels of the two groups showed an upward trend at T1 and T2 and a downward trend at T3 and T4. And, at T4, the decrease in CRP level of the research group was greater than that in the control group, and the difference was statistically significant ( < 0.05). Before nursing, there was no statistically significant difference between two groups of patients in the time to fall asleep, sleep time, number of awakenings, SAS score, self-rating depression scale (SDS) score, quality of life index scores, and total scores ( > 0.05). After nursing, the time to fall asleep and the number of awakenings in the two groups of patients showed an upward trend, and the increase in the control group was higher ( < 0.05). The sleep time of the two groups showed a downward trend, and the degree of decline in the control group was higher ( < 0.05). After nursing, the SAS score and SDS score of the two groups of patients decreased ( < 0.05), and the decrease in the research group was more obvious ( < 0.05). After nursing, the scores of all indicators of the quality of life and the total score of the two groups increased and the score of the research group increased more significantly ( < 0.05). After nursing, the control group had 5 cases of gastrointestinal reactions, 7 cases of bone marrow suppression, 6 cases of leukopenia, 6 cases of thrombocytopenia, and 10 cases of dizziness and nausea. In the research group, there were 1 case of gastrointestinal reaction, 2 cases of bone marrow suppression, 1 case of leukopenia, 1 case of thrombocytopenia, and 2 cases of dizziness and nausea. The difference between the two groups was statistically significant ( < 0.05).
Glioma patients are given high-quality care during the course of concurrent radiotherapy and chemotherapy, which can reduce the pain and bad mood of the patient, reduce the stress response of the patient, and improve the quality of sleep and the quality of life of the patient, thereby improving nursing satisfaction and patients compliance, reducing adverse reactions, and having a good prognosis.
本研究旨在探讨高质量护理在脑胶质瘤术后同步放化疗中的临床价值及其对皮质醇（Cor）、促肾上腺皮质激素（ACTH）和 C 反应蛋白（CRP）等应激指标的影响。
将我院收治的 94 例脑胶质瘤患者随机分为研究组和对照组，每组 47 例。两组患者均给予同步放化疗，在此基础上，对照组患者给予基础护理，研究组患者给予基础护理联合优质护理。比较两组患者的护理满意度及不良反应。比较两组患者不同时间点疼痛程度及应激指标 Cor、ACTH、CRP 水平。比较两组患者护理前后睡眠质量、不良情绪及生活质量。
护理后，研究组护理满意度（95.74%）高于对照组（80.85%），差异有统计学意义（ = 11.678， < 0.05）。两组患者视觉模拟评分量表（VAS）评分及 Cor、ACTH 应激指标水平在 T1 时间点比较，差异均无统计学意义（ > 0.05）。随着时间的推移，两组患者 Cor 和 ACTH 水平呈上升趋势。T4 时，研究组 Cor 和 ACTH 升高水平低于对照组，差异有统计学意义（ < 0.05）。两组患者 VAS 评分及 CRP 水平在 T1、T2 时呈上升趋势，在 T3、T4 时呈下降趋势。T4 时，研究组 CRP 水平下降幅度大于对照组，差异有统计学意义（ < 0.05）。护理前，两组患者入睡时间、睡眠时间、觉醒次数、焦虑自评量表（SAS）评分、抑郁自评量表（SDS）评分、生活质量指数评分及总分比较，差异均无统计学意义（ > 0.05）。护理后，两组患者入睡时间和觉醒次数呈上升趋势，对照组升高幅度较高（ < 0.05）。两组患者睡眠时间呈下降趋势，对照组下降幅度较高（ < 0.05）。护理后，两组患者 SAS 评分和 SDS 评分均降低（ < 0.05），研究组降低幅度更为明显（ < 0.05）。护理后，两组患者生活质量各指标评分及总分均升高，且研究组升高幅度更为显著（ < 0.05）。护理后，对照组出现胃肠道反应 5 例、骨髓抑制 7 例、白细胞减少 6 例、血小板减少 6 例、头晕恶心 10 例；研究组出现胃肠道反应 1 例、骨髓抑制 2 例、白细胞减少 1 例、血小板减少 1 例、头晕恶心 2 例。两组比较，差异有统计学意义（ < 0.05）。
脑胶质瘤患者在同步放化疗过程中给予高质量护理，可减轻患者疼痛和不良情绪，降低患者应激反应，提高患者睡眠质量和生活质量，从而提高护理满意度和患者依从性，降低不良反应，改善预后。
