【摘要】：目的：(1)探討青年宮頸癌放療后患者使用陰道模具預(yù)防陰道狹窄的臨床效果。(2)探討青年宮頸癌放療后患者使用陰道模具對(duì)患者性生活質(zhì)量的影響。(3)探討青年宮頸癌放療后患者使用陰道模具預(yù)防陰道狹窄的安全性和可行性。方法：選擇2014年1月～2014年6月在浙江省腫瘤醫(yī)院婦瘤科行放射治療的青年官頸癌患者為研究人群,根據(jù)納入、排除標(biāo)準(zhǔn)選取110例患者,隨機(jī)分為觀察組55例,對(duì)照組55例。對(duì)照組患者行常規(guī)護(hù)理,放療期間每日由護(hù)士進(jìn)行陰道沖洗,出院以后要求患者自行陰道沖洗,每日一次,持續(xù)一年,放療結(jié)束3個(gè)月后恢復(fù)性生活。觀察組患者在常規(guī)護(hù)理的基礎(chǔ)上,于放療結(jié)束時(shí)指導(dǎo)患者居家階段采用專用的陰道模具每周進(jìn)行大于等于3次陰道擴(kuò)張,每次擴(kuò)張持續(xù)5分鐘,持續(xù)1年以上。比較觀察組和對(duì)照組患者陰道狹窄發(fā)生率、陰道狹窄程度、性生活恢復(fù)情況以及女性性功能量表(FSFI)分值差異。結(jié)果：項(xiàng)目實(shí)施過(guò)程中,本研究共募集組觀察組55人,對(duì)照組55人,觀察組脫落6人,對(duì)照組脫落5人,最終納入統(tǒng)計(jì)分析的青年宮頸癌患者總數(shù)為99例,觀察組49例,對(duì)照組50例。觀察組患者陰道狹窄的發(fā)生率為22.45%,均為Ⅰ級(jí)陰道狹窄,對(duì)照組患者陰道狹窄的發(fā)生率為60.00%,其中Ⅰ級(jí)陰道狹窄為30.00%，Ⅱ級(jí)陰道狹窄為30.00%,差異有統(tǒng)計(jì)學(xué)差異(P0.05)。至放療結(jié)束后12個(gè)月,觀察組患者性生活恢復(fù)率為81.64%,對(duì)照組為54.00%,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。觀察組患者恢復(fù)性生活的時(shí)間為放療結(jié)束后9.24±2.57個(gè)月,對(duì)照組患者恢復(fù)性生活的時(shí)間為放療結(jié)束后9.78±3.11個(gè)月,兩組比較無(wú)顯著性差異(P0.05)。觀察組患者每月性生活次數(shù)3.00±1.90次,對(duì)照組患者每月性生活次數(shù)1.62±1.87次,兩組比較存在顯著差異(P0.05)。觀察組FSFI問(wèn)卷總分18.163±8.795分,對(duì)照組總分12.740±8.389分,兩組比較存在顯著性差異(P0.05)。模具使用過(guò)程中無(wú)1例發(fā)生模具相關(guān)的并發(fā)癥。結(jié)論：(1)青年宮頸癌患者放療后使用陰道模具能有效降低陰道狹窄的發(fā)生率；(2)青年官頸癌患者放療后使用陰道模具能促進(jìn)患者恢復(fù)性生活,提高性生活質(zhì)量；(3)青年宮頸癌放療后患者使用陰道模具預(yù)防陰道狹窄是安全、可行的。
[Abstract]:Objective: (1) to investigate the clinical effect of vaginal mould on prevention of vaginal stricture in young patients with cervical cancer after radiotherapy. (2) to investigate the effect of vaginal mould on sexual life quality of young patients with cervical cancer after radiotherapy. (2) to investigate the effect of vaginal mould on sexual life quality of young patients with cervical cancer after radiotherapy. 3) to investigate the safety and feasibility of using vaginal mould to prevent vaginal stricture in young patients with cervical cancer after radiotherapy. Methods: from January 2014 to June 2014, 110 young patients with cervical cancer who underwent radiotherapy in the Department of Gynecology, Zhejiang Cancer Hospital were randomly divided into observation group (n = 55) and control group (n = 55). The patients in the control group were treated with routine nursing. During radiotherapy, the nurses were washed with vagina every day. After discharge, the patients were asked to rinse their own vagina once a day for one year. After 3 months of radiotherapy, the patients were asked to resume their sex life. On the basis of routine nursing, the patients in the observation group were given vaginal dilatation more than or equal to 3 times a week at the end of radiotherapy. Each dilatation lasted for 5 minutes and lasted for more than 1 year. The incidence of vaginal stricture, the degree of vaginal stricture, the recovery of sexual life and the (FSFI) score of female sexual function scale were compared between the observation group and the control group. Results: during the implementation of the project, there were 55 cases in the observation group, 55 cases in the control group, 6 cases in the observation group and 5 cases in the control group. The total number of young cervical cancer patients included in the statistical analysis was 99 cases and 49 cases in the observation group. There were 50 cases in the control group. The incidence of vaginal stricture was 22.45% in the observation group and 60.00% in the control group, including 30.00% in grade I vaginal stenosis and 30.00% in grade II vaginal stenosis. The difference was statistically significant (P 0.05). 12 months after radiotherapy, the sexual recovery rate of the observation group was 81.64%, and that of the control group was 54.00%, the difference was statistically significant (P 0.05). The time of resuming sexual life was 9.24 鹵2.57 months after radiotherapy in the observation group and 9.78 鹵3.11 months after radiotherapy in the control group. There was no significant difference between the two groups (P 0.05). The monthly sexual life times of the patients in the observation group were 3.00 鹵1.90 times, while those in the control group were 1.62 鹵1.87 times per month. There was a significant difference between the two groups (P 0.05). The total score of FSFI questionnaire was 18.163 鹵8.795 in the observation group and 12.740 鹵8.389 in the control group. There was significant difference between the two groups (P 0.05). No complications related to mould occurred in the process of mould use. Conclusion: (1) vaginal mould can effectively reduce the incidence of vaginal stricture in young patients with cervical cancer after radiotherapy, (2) vaginal mould can promote the recovery of sexual life and improve the quality of sexual life in young patients with cervical cancer after radiotherapy. (3) it is safe and feasible for young patients with cervical cancer to use vaginal mould to prevent vaginal stenosis after radiotherapy.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R473.73

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 葛永勤;徐麗麗;李雪芬;劉寧;劉敏;于巧萍;;專項(xiàng)化護(hù)理干預(yù)對(duì)育齡期宮頸癌病人術(shù)后性生活質(zhì)量的影響[J];護(hù)理研究;2014年20期

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