目的 探讨食管癌同步放化疗期间肠内营养支持治疗和护理干预的临床效果.方法 选取2016年1月至2017年8月蚌埠医学院第一附属医院收治的74例食管癌行同步放化疗治疗的患者作为研究对象,随机分为观察组和对照组,每组37例.对照组给予肿瘤科常规护理干预,观察组实施肠内营养支持和综合护理干预,比较两组患者治疗前、治疗后2周、4周时营养学指标血红蛋白(Hb)、白蛋白(ALB)、淋巴细胞计数(Lc)和体质指数(BMI)差异;采用Spitzer生活质量指数(SQLI)对患者治疗前后生活质量进行评估,比较两组患者治疗前、治疗后4周的SQLI评分差异.结果 治疗后4周,观察组Hb、ALB、Lc和BMI均高于对照组,差异均有统计学意义(P＜0.05).两组患者治疗前SQLI评分差异无统计学意义,治疗后4周观察组SQLI总分以及活动能力、生活感受、健康感受评分均高于对照组,差异均有统计学意义(P＜0.05).结论 食管癌同步放化疗期间并发营养不良十分常见,肠内营养支持和综合护理干预有助于改善患者营养状态,提高生存质量

目的 总结恶性胶质瘤术后患者行放疗联合替莫唑胺同步化疗期间的护理方法.方法 选取2013年9月～2015年11月间我院收治恶性胶质瘤术后患者共27例,对同步放化疗期间出现的不良反应实施针对性护理干预.结果 经过科学有效的护理干预,27例患者均完成治疗过程,无严重并发症的发生.结论 护理干预对恶性胶质瘤术后患者行放疗联合替莫唑胺同步化疗的顺利进行有重要作用,有助于缓解患者痛苦,提高依从性.

Objective To explore the application of the evidence-based care for esophageal cancer patients receiving radiotherapy.Methods According to evidence-based method to retrieve relevant documents,then to evaluate the authenticity,the reliability and clinical utility of the evidence,the final adoption of evidence-based care strategies,the objects of these works above are to release the psychological pressure and to reduce the patient radiation reactions and complications.Results Request for certificate of care for patients with esophageal cancer,it was found that the apparent effects accounted for 80.3%,88.6% effective,invalid(11.4%),death(0%),and therefore through the application of evidence-based care in patients with esophageal carcinoma,taking effective care measures can ease the patient's psychological pressure,reduce the incidence of radiation side effects and complications,and thereby improving patient outcomes.Conclusion To patients treated with radiotherapy for esophageal cancer,evidence-based care can be effective in reducing the incidence of radiation side effects and complications,reducing the psychological pressure,and ensuring that patients with the successful completion of radiation therapy,it was recommended that the request for certificate should care be promoted in patients with esophageal carcinoma.

Objective To investigate care on patients with esophageal carcinoma with intensity modulated radiation therapy( IMRT),to prevent and alleviate the side effects of radiotherapy on patients with esophageal carcinoma,to ensure the smooth completion of the radiotherapy treatment planning of patients and to improve quality of life of patients. Methods To careful nursing,from mental nursing irradiated skin care,diet nursing care,nursing of radiation esophagitis,prevention of bone marrow suppression and nursing care of radioactive were conducted. Results The results of all 45 patients successfully completed the entire process of radiotherapy,had recently reached 95. 6 percent efficiency. While all the patients with lower radioactive esophagitis and pneumonitis and cutaneous radiation reaction of light,also with lower incidence of myelosuppression. Conclusion Careful clinical nursing was one of the key factors to alleviate the side effects of radiotherapy and ensure the smooth completion of the radiotherapy treatment planning of patients.

Objective To explore the effects of two different position fixing methods on the precision of re-position in patients with chest tumor receiving radiotherapy.Methods Thirty cases with chest tumor receiving radiotherapy were randomly divided into two groups:vacuum cushion fixed position group and low-temperature thermoplastic membrane fixed position group.Simulation films and portal verification films under the simulator and the electron linear accelerator were separately photographed.The chip beam center was positioned for the coordinates in simulation films,and the deviation of beam center in the X-axis,Y-axis,and Z-axis were calculated.Results The deviation distance with beam center in the X-axis,Y-axis,and Z-axis in the vacuum cushion group and thermoplastic membrane group were(1.37 ± 1.31) mm vs.(1.35 ± 1.29) mm(P 0.05),(1.33 ± 1.14) mm vs.(1.26 ± 1.12) mm(P 0.05),and(2.17 ± 1.54) mm vs.(1.47 ± 1.32) mm(P 0.01),respectively.Conclusion Position fixation with thermoplastic membrane in radiotherapy is better than vacuum cushion for chest tumor,which can reduce position deviation of the pendulum,so as to enhance the treatment positioning accuracy degrees.

Objective To analyze the effect of clinical temporomandibular joint (TMJ) functional training for prevention of trismus in nasopharyngeal carcinoma (NPC) patients treated with radiotherapy.Methods According to the performance of patients clinical TMJ functional training, 43 NPC patients treated with three-dimensional conformal radiation therapy (3DCRT) and 82 NPC patients treated with general twodimensional radiation therapy were assigned respectively to the study group and the contrast group. The clinical TMJ functional training on patients of the study group was performed regularly and intensively under good guidance and supervision from the beginning of radiotherapy. The clinical TMJ functional training on patients of the contrast group was performed without such strict supervison after the first guidance. The size of the distance was measured between the incisors of the patients of the study group and the contrast group before radiotherapy and the final follow-up within two years after radiotherapy. Results The reduction of the distance between the incisors were [(0.64±0.59) cm] in the study group of 3DCRT in contrast to the [(0.81±0.64) cm] in the contrast group (P ＞0.05). The incidence of trismus was 8.1% in the study group of 3DCRT in contrast to the 21.1% in the contrast group (P ＞0.05); The reduction of the distance between the incisors were [(0.72±0.65) cm] in the study group of general two-dimensional radiotherapy in contrast to the [(1.64±0.73) cm] in the contrast group (P ＜0.01). The incidence of trismus was 19.0% in the study group of general two-dimensional radiotherapy in contrast to the 47.5% in the contrast group (P ＜0.01). Conclusion TMJ Functional training method is the good method that can lower the severity and the incidence of trismus in NPC patients treated with radiotherapy. It is more evident and more important for patients with general twodimensional radiotherapy.

Objective To investigate the clinical nursing and correlative precautions of patients with nasopharyngeal carcinoma who received three-dimensional conformal radiotherapy(3DCRT).Methods The whole nursing intervention was performed in 12 cases of nasopharyngeal carcinoma by 3DCRT.Results The entire process of radiotherapy was carred out with a short term response rate of 91.7%.The patients showed mild reaction in skin and oral mucosa,and lower incidence of myelosuppression.Conclusion The appropriate clinical care will decrease the side reaction of 3DCRT in patients with nasopharyngeal,and improve QOL of patients.