头颈部肿瘤患者放疗期间联合使用西妥昔单抗后口咽部细菌感染风险回归模型探讨及护理

Nursing Research and Study on the Combined Treatment with Radiotherapy and Cetuximab on the Increased Risk of Oropharynx Bacteria in the Head and Neck Neoplasms Patients

关键词:  头颈部肿瘤  放射性口腔黏膜炎  西妥昔单抗  感染风险  护理

Key words:  head and neck tumor  radioactive oral mucositis  cetuximab  risk of infection  nursing

摘要:

目的 探讨头颈部肿瘤患者放疗期间联合使用西妥昔单抗后口咽部发生细菌感染的情况及相关影响因素，并在此基础上提出有效的护理措施。方法 对近2年内在笔者所在医院接受治疗的206例头颈部肿瘤患者的临床资料进行了回顾分析，采集所有患者咽拭子样本进行送检，根据送检样本是否发生感染将本次206例患者分为感染组和非感染组，同时收集可能影响口咽部细菌感染的相关因素指标，采用Logistic回归分析对口咽部细菌感染的独立危险因素进行评估。结果 本次206份咽拭子样本，共检测出细菌感染102份，占总样本数的49.5%；2组患者的年龄构成比差异及使用西妥昔单抗构成差异具有显著性(P<0.05)，T分期构成比差异及使用尼妥珠单抗构成比差异具有边缘显著性(P=0.059，0.054)，而其他因素的组间构成比差异均不具有显著性；Logistic回归分析结果表明，年龄、T分期及是否使用西妥昔单抗是发生口咽部细菌感染的高危因子。结论 高年龄、高T分期及使用西妥昔单抗可增加头颈部肿瘤患者放疗期间口咽部感染的风险和程度，在头颈部肿瘤患者接受放疗治疗的过程中，尤其应对高T分期且使用过西妥昔单抗的高龄患者加强护理。

Abstract:

OBJECTIVE To investigate the combination treatment with radiotherapy and cetuximab on the increased risk of oropharynx bacteria in the head and neck neoplasms patients, and some effective nursing measure were put forward. METHODS The clinical data of 206 cases with head and neck cancer were analyzed retrospectively in the recent two years. Throat swab specimens were obtained from patients for etiological tests. All patients were divided into infected group and uninfected group according to whether infection. collected may suit related factors that affect the pharyngeal bacterial infection index. then the clinically relevant factors for bacteria-positive throat swab cultures were evaluated for their predictive effect using the ordered logistic regression. RESULTS A total of 102 cases(49.5%) presented postitive results of bacterial infected. The age-related rate and administration of cetuximab in the two groups had significant difference (P<0.05). T stage-related rate and administration of nimotuzumab in the two groups had edge significant difference (P=0.059, 0.054). and other factors had no significant difference in the two groups. The result of Logistic Regression Analysis showed that the age, T stage and administration of cetuximab were high-risk factors of oropharynx bacteria in the head and neck neoplasms patients. CONCLUSION The high age, T stage and administration of cetuximab can increase the risk of throat infection and degree in head and neck cancer patients during radiotherapy. The corresponding nursing counter measures need to be taken for eldly patients which are high T stage and administration of cetuximab during radiation period.