杨维萍　祝志娟　徐国英

[关键词] 预见性护理;乳腺癌;放疗;放射性皮炎

[中图分类号] R473.71          [文献标识码] B          [文章编号] 1673-9701（2021）18-0159-04

The effect of predictive nursing intervention on reducing the skin reaction of breast cancer after radiotherapy

YANG Weiping1   ZHU Zhijuan2   XU Guoying1

1.Department of Oncology and Radiotherapy， the General Hospital of Medical Community of Shaoxing Second Hospital in Zhejiang Province， Shaoxing   312000， China; 2.Department of Public Health， the General Hospital of Medical Community of Shaoxing Second Hospital in Zhejiang Province， Shaoxing   312000， China

[Abstract] Objective To analyze the effect of predictive nursing intervention on reducing the skin after breast cancer radiotherapy. Methods A total of 83 breast cancer patients treated in our hospital from March 2018 to March 2019 were selected as the observation group， and 83 breast cancer patients admitted to our hospital from February 2016 to February 2017 were selected as the control group. The control group was given routine nursing，and the observation group was given a predictive nursing intervention model based on routine care. The quality of life，the degree of radiation dermatitis，and the time of radiation skin reaction were compared between the two groups. Results The quality of life score of the observation group was （105.25±16.94） points， which was significantly higher than that of（92.13±14.68）points in the control group， with significant difference（P<0.05）. The incidence of radiation dermatitis above grade II in the observation group was 42.17%， which was significantly lower than that of 75.90% in the control group， with significant difference（P<0.05）. The occurrence time of radiation dermatitis in the observation group was（16.05±1.73）days，which was significantly longer than that of（13.27±1.44） d in the control group， with significant difference（P<0.05）. Conclusion Predictive nursing can effectively reduce the skin reaction after breast cancer radiotherapy and improve the quality of life. It is worthy of clinical promotion.

[Key words] Predictive nursing; Breast cancer; Radiotherapy; Radiation dermatitis

隨着医疗水平的不断发展，放射治疗（简称放疗）在乳腺癌综合治疗中占有重要地位。放疗在乳腺癌术后辅助放疗、局部复发控制以及转移性乳腺癌治疗中扮演重要角色[1]，不仅能够有效提高其生存率，还能显著改善患者症状、减轻其痛苦、提高其生活质量。但放疗可导致一系列不良反应，其中皮肤损伤是常见的不良反应，严重者导致治疗中断，影响放疗的进程，还会增加患者新的痛苦，降低其生活质量。预见性护理以先预防后治疗为原则[2]，护理人员根据患者的病情进行综合分析、判断，运用医学专业知识，预见性的发现问题，及时采取相应的护理干预措施，使护理工作由被动变主动。预见性护理已广泛用于临床多种疾病治疗后并发症的预防，如胆结石手术、急诊抢救、冠心病介入治疗、骨科手术[3-5]等。本研究分析预见性护理应用于乳腺癌放疗后皮肤损伤的预防效果，现报道如下。

1 资料与方法

1.1 一般资料

选取2018年3月至2019年3月我院收治的83例乳腺癌放疗患者为观察组，均为女性，其中根治术60例，保乳术23例。回顾性分析我院2016年2月至2017年2月收治的83例乳腺癌患者为对照组。纳入标准[6]：①经病理学诊断为乳腺癌且行放疗者，放疗时间4～6周;②年龄18～65岁;③放疗前均未接受过化疗者;④无放疗禁忌证，无其他皮肤疾病，且未使用过皮肤护理品者。排除标准[7]：①有精神障碍者;②存在皮肤病变或皮肤超敏感者;③未按疗程放化疗者。……