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1、乳腺癌化疗期的心理干预乳腺癌近年来逐渐成为严重危害妇女健康的恶性肿瘤之一, 化疗作为一种有效的治疗方法 ,以巩固疗效 ,降低术后复发率 ,延长其生存期 ,可以弥补手术治疗的不足。由化疗引起的不良反应如脱发、便秘、呕吐, 厌食 , 焦虑等给患者的身心健康造成了严重的影响。进行心理上的治疗可减轻乳腺癌化疗患者的焦虑状态,使之在治疗期拥有良好的心情 , 从而积极配合治疗和护理。据相关报道 ,60% 伴有焦虑抑郁情绪的患者没有得到任何心理咨询或心理治疗。 这不仅降低了患者生存质量 ,而且降低了患者接受治疗的配合性 , 影响了癌症治疗结局。本文旨在探讨心里干预对乳腺癌化疗后患者生存质量的影响。Breas
2、t cancer in recent years gradually become one of serious harmto the health of women malignant tumor, chemotherapy as an effectivetreatmentmethod,in orderto consolidatecurativeeffect,reducethepostoperative recurrence rate and prolong the survival period, can makeup for the inadequacy of surgical trea
3、tment. Caused by chemotherapyadversereactionssuch as hair loss, constipation,vomiting,anorexia,anxietyto thepatients physicaland mentalhealth causedseriousinfluence. Psychological therapy can reduce the anxiety state of breastcancer patients with chemotherapy, to phase in the treatment with goodmood
4、,toactivelycooperatewithtreatmentandcare. Accordingtoreports,60%ofpatientswithanxiety,depressionreceivednocounselingorpsychologicaltreatment.Thisnotonlyreducesthe1survivalquality,and reducethepatientstreatedwithsex,affectsthecancer treatment outcome. The purpose of this paper is to discuss thein the
5、 mind interfere the influence of the quality of life in patients withbreast cancer after chemotherapy.1 化疗前的心理干预One chemotherapy before psychological intervention1.1乳腺癌患者得知自己患有癌症之后, 心理会出现不同程度的障碍。如愤怒、恐惧和焦虑等 ,因此医生要及时与患者建立良好的医护关系, 了解患者的内心动向 ,给予及时的疏导。并且根据患者受教育程度、对乳腺癌的掌握程度, 针对性的开展乳腺癌知识教育。讲解临床治疗的方案和预后情况 ,
6、 消除患者对疾病的恐惧感。医生应向患者或家属介绍化疗药物的作用、 使用方法、不良反应及预防措施 ,让患者采取相应的防范措施 ,减轻化疗反应 ,保持良好的精神状态 ,消除患者的紧张、恐惧情绪 ,配合治疗。1.1 breast cancer patients after learned that he had cancer, mentalwillappeardifferentdegreeofobstacles.Suchas anger,fearandanxiety,so thedoctortotimelyandbuildup goodrelationshipwithmedicalpatients,
7、understandthepatientsheart,togivetimelyguidance.Andaccordingtothepatientslevelofeducation,masterdegreeofbreastcancer,targetedtocarryoutthebreastcancer2knowledge education. Interpretation of the clinical treatment plan andprognosis,toeliminatepatientstothefearofthedisease.Surgeonshouldintroducetherol
8、eofchemotherapydrugstothepatientorfamilymember,methodofuse,adversereactionandpreventionmeasures, make patients to take corresponding measures to prevent,reduce chemotherapy response, keep good mental state, toeliminatepatients tension, fear, and cooperate with treatment.1.2要给患者树立治疗的信心,大部分患者化疗前担心脱发、
9、恶心呕吐 , 失眠 ,厌食等症状发生。因此要由专门医生根据患者个人情况、背景条件, 心理状态 ,做好心理护理。针对患者不同的心理状态有选择性地进行心理疏导, 以减轻焦虑、恐惧、抑郁等不良情绪反应。同时要运用医学知识、心理知识给予科学的解释,帮助患者克服负性情绪。 运用典型病例、宣传资料等让患者知道随着医学的发展,癌症不可怕 ,增强其治疗的信心。找同类型处于康复期的患者现身说法 ,让患者亲身感受到化疗的效果。 告诉患者化疗中出现的如脱发、 腹泻、呕吐等现象都是暂时的 ,化疗结束以后 , 可恢复 ,如果患者脱发严重 ,可选择戴帽子或选择戴假发来减少脱发带来的不便。1.2tobuildup myco
10、nfidenceinthetreatmentofpatients,themajorityofpatientsbeforechemotherapyworriedabouthairloss,nausea, vomiting, insomnia, loss of appetite and other symptoms occur.So bephysiciansaccordingtopatientspersonalcircumstances,byspecificbackgroundconditions,psychologicalstate,completesthe3psychologicalnursi
11、ng.Inviewofthedifferentpsychologyofthepatients selectively to psychological counseling, to alleviate the anxiety,fear,depressionandotheradverseemotionalresponse.Atthesametime, we should use the medical knowledge, psychological knowledgeto give scientific explanation, help people overcome negative em
12、otions.Using the typical cases, promotional materials, etc. Let the patient knowthat with the development of medicine, cancer is not terrible, enhancetheirconfidenceof treatment.Lookingfor the same type patientsinconvalescence, enable patients to feel the effect of chemotherapy. Tellpatients in the
13、chemotherapy of the phenomenon such as such as hairloss, diarrhea, vomiting, are temporary, after the chemotherapy, can berestored, ifhairlossis severe,patientscanchoose towearahatorchoose to wear a wig to reduce hair loss inconvenience.1.3很多乳腺癌女性担心化疗后会改变自己的形象, 失去自己在丈夫心中的魅力 ,担心以后的生活等。护理人员应教育患者家属尽可能抽
14、出时间,倾听患者的心声 ,了解她们的内心深处的感受,不离不弃地照护她们。1.3 many women worried about breast cancer after chemotherapycan changetheirimage,have losttheircharmin herhusbandheart,worryaboutfuturelife,etc.Nursingstaffshouldeducationpatientsfamilies as much as possible time, listen to the heart-felt wishes of the4patients,
15、to understand their inner feelings, leave to care for them.家庭的支持可以增强患者抗争疾病的信心, 抵御疾病的能力 , 通过与家人心灵上的交流 , 泰山奇石可以分散患者对疾病和自身缺陷的关注度 , 增强患者的抗癌能力。2 化疗期间的心理干预Family support can enhance the confidence of the struggle againstdisease patients, to resist the ability of the disease, through the spiritualcommunica
16、tionwithfamily,tospreadawarenessofdiseasesandpatients with defects, the ability of patients with cancer. 2 psychologicalintervention during chemotherapy治疗期间患者一旦出现毒副作用便会感觉到极大的痛苦, 此时 , 医生要做好患者的心理护理工作, 给予患者更多的心理上的支持和鼓励, 增强患者治疗的信心。为了减少化疗期间胃肠道反应,恶心、呕吐的发生 ,在化疗前给予静脉推注止吐药物 ,如托烷司琼、甲氧氯普胺等 ; 化疗前不要进食 ,化疗后进食易消化食
17、物。 少食多餐 ,忌食辛辣、刺激性食物的护理 ; 化疗 期间在安静的环境下休息,听轻音乐 ,保持良好的心情。链条大部分乳腺癌患者化疗后免疫功能低下,手术的创伤及化疗药物又加重了对机体的损害, 各种侵入性操作均增加了感染的可能性, 因此在化疗期间应采取一切必要措施预防置管感染的发生,以减少患者的心里负担。During treatment patients once appear side effects will be felt great5pain, atthis point, thedoctorswilldoa goodjobinthepatientspsychological nursin
18、g for patients with more psychological support andencouragement, and enhance the confidence of the patients. In order toreducethechemotherapyduringgastrointestinalreaction,theoccurrenceofnausea,vomiting,beforechemotherapygivenintravenous anti-nausea drug injection, such as tropane SiQiong, aminemeth
19、oxychlor tome, etc; Dont eat before chemotherapy, chemotherapyaftereateasyto digestfood.Eat muchfood less,dietisacrimony,excitant food nursing; During chemotherapy in a quiet environment torest, listen to soft music,keep agoodmood.Mostbreastcancerpatients after chemotherapy, immune function is low,
20、trauma surgeryand chemotherapy drugs and aggravates the damage to the body, allkinds of invasive operations have increased the possibility of infection,soduringtheperiodofchemotherapyshould takeallnecessarymeasures to prevent the happening of the catheter infection, in order toreduce the patients he
21、art burden.乳腺癌的化疗持续时间长, 通常需要36个月 , 大剂量的药物及反复多次静脉穿刺易损伤血管, 直接造成机械性静脉炎,同时由于药物的高浓度可致化学性静脉炎。从锁骨下静脉输入多西紫杉醇及表阿霉素, 输入的药物可被稀释 , 对静脉内膜不造成损害 ,同时又不会反复穿刺静脉 ,防止了表阿霉素等的外渗 ,不会造成局部坏死及机械性静脉炎。 泰安车库门此方案可以减少患者的痛苦。 化疗药物对恶性细胞杀伤的同时也会对人体正常的组织引起不同程度的损害, 特别是毛发等6损害更为明显。帽子、假发是化疗期间的必备品。同时, 化疗期间应避免刺激性强的洗发用品。Longtimebreastcancerch
22、emotherapy,usuallyneedto3 6months, largedosesofdrugsandrepeatedvenipunctureiseasytodamage blood vessels, mechanical phlebitis caused by directly, at thesametimeduetoa highconcentrationofdrugscancausechemicalphlebitis. Input from subclavian vein docetaxel and table doxorubicin,inputofdrugscanbedilute
23、d,theveinliningisnotdamage,notrepeatedpuncturevein againatthesametime,topreventthetableextravasation of doxorubicin, etc, will not result in a partial necrosis andmechanicalphlebitis.Thisschemecanreducethepainofpatients.Chemotherapydrugstokillmalignantcellsat thesametime,it willcause different degre
24、e of damage to the human body normal tissues,especially hair damage is more apparent. Hats, wigs is necessary duringchemotherapy. At the same time, should avoid excitant strong shampooduring chemotherapy.乳腺癌患者在化疗期采用有效的心理干预,可以提高乳腺癌患者化疗依从性,降低抑郁焦虑发生的可能性,提高患者化疗后的生存质量。矿用声光报警器值得临床推广应用。Breastcancerpatientsduringchemotherapyperioduseeffective7psychologicalinterventioncanimprovepatientswithbreastcancerchemotherapycompliance,reducethelikelihoodofdevelopingdepression anxiety, improve the quality of patients after chemotherapy.Worthy of clinical popularization and application.8