黄春兰 丁金泉 王丽萍 李丽华 李锦秀

[摘要] 目的 探讨临床护理路径在头颈部肿瘤放射治疗中的应用效果。 方法 选择2014年1～12月在我院行头颈部肿瘤放射治疗的患者60例为研究对象，随机分为干预组和对照组，各30例，干预组采用临床护理路径护理，对照组采用头颈部肿瘤放射治疗常规护理，比较两组患者心理、手术情况、手术并发症发生率等情况。 结果 干预组症状自我评估量表中焦虑、敌对、偏执、恐怖、躯体化、人际关系、抑郁、强迫症状、精神病症、及SCL总分得分均显著低于对照组（P<0.01）；干预组等候放疗时间、住院时间短于对照组（P<0.01）；住院费用显著低于对照组（P<0.01）；干预组护理满意率及健康教育达标率均显著高于对照组（P<0.05）。 结论 头颈部肿瘤放射治疗的患者采用临床护理路径管理，能够显著改善患者的心理状态、缩短放疗前的准备时间、缩短住院时间、降低住院费用，提高护理满意率及健康教育达标率。

[关键词] 头颈部肿瘤；放射治疗；临床护理路径

[中图分类号] R653 [文献标识码] A [文章编号] 1674-4721（2016）02（a）-0173-03

Clinical nursing path in head and neck cancer radiation therapy

HUANG Chun-lan DING Jin-quan WANG Li-ping LI Li-hua LI Jin-xiu

Department of Radiation Therapy Technology，Tumour Hospital of Ganzhou City in Jiangxi Province，Ganzhou 341000， China

[Abstract] Objective To discuss application efficacy of clinical nursing path in head and neck cancer radiation therapy. Methods 60 cases with head and neck cancer radiation therapy from Janary to December 2014 were selected as subjects.All cases were divided into intervention group and control group，each of 30 cases.Intervention group was nursed with clinical nursing path，and control group was nursed with routine care.Psychological，surgical situation，surgical complication rates of two groups was compared. Results Anxiety，hostility，paranoia，terror，somatization，interpersonal sensitivity，depression，obsessive-compulsive symptoms， psychiatric disorders，and SCL score of intervention group were lower than that of control group（P<0.01）.Radiotherapy waiting time，length of stay of intervention group were shorter than that of control group（P<0.01）.Hospitalization costs significantly lower than that of control group （P<0.01）.Nursing satisfaction rate and health education compliance rate of intervention group were higher than that of control group（P<0.05）. Conclusion Clinical nursing path in head and neck cancer radiation therapy can improve patient′s mental state，shorten the preparation time before radiotherapy，shorten the length of stay，reduce hospital costs，and improve nursing satisfaction rate and health education compliance rate.

[Key words] Head and neck cancer；Radiation therapy；Clinical nursing path

头颈部肿瘤除具有一般恶性肿瘤的特征外，还具有一些独特的特征，其影响呼吸、消化、内分泌、视听说功能。放射治疗或者以放射治疗为主的综合治疗是治疗头颈部肿瘤的基本原则，患者在放疗过程中容易发生乏力、纳差、骨髓抑制、放射性皮炎、黏膜炎等，放射治疗后容易发生照射部位黏膜干燥、皮肤及软组织纤维化、唾液分泌减少及感染等并发症[1-2]。临床护理路径是近年来在临床上推广的一种护理理念，研究显示临床护理路径能够达到更好的护理效果，缩短住院时间，降低住院费用[3-4]。本研究探讨临床护理路径在头颈部肿瘤放射治疗中的应用效果，现报道如下。

1 资料与方法

1.1 一般资料

选择2014年1～12月在我院治疗的头颈部肿瘤放疗患者60例为研究对象。随机分为干预组和对照组，各30例。干预组男19例，女11例，年龄35～70岁，平均（57.1±10.6）岁；……