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专家述评

肠道支架治疗梗阻性结直肠癌的治疗现状

Current status of intestinal stent therapy for obstructive colorectal cancer

:396-401
 
       约10%~30%的新发结直肠癌患者会出现急性肠梗阻,传统急诊手术治疗存在术后并发症高、死亡率高、生存质量低等不足。肠道支架置入联合限期手术作为一种新型治疗策略,展现出显著优势。肠道支架可迅速解除梗阻,改善患者症状,降低手术风险,为肿瘤微创切除创造条件,同时为新辅助化疗提供可能,但其潜在并发症如出血、移位、再梗阻及肠穿孔等也不容忽视,且长期安全性及对肿瘤结局的影响尚不明确。文章综述了肠道支架治疗梗阻性结直肠癌的治疗现状、争议及研究进展,旨在为临床研究和实践提供参考依据。
    Approximately 10% to 30% of patients with newly diagnosed colorectal cancer present with acute intestinal obstruction.Traditional emergency surgical intervention is characterized by high rates of postoperative complications,elevated mortality,and diminished quality of life.Combined stent and curative elective surgery(CSCES)has emerged as a novel therapeutic strategy,exhibiting significant clinical benefits.Intestinal stenting can rapidly alleviate obstruction,thereby improving patient symptoms,reducing surgical risks,and facilitating minimally invasive tumor resection.Additionally,it provides an opportunity for neoadjuvant chemotherapy.However,potential complications,including bleeding,stent migration,recurrent obstruction,and intestinal perforation,must be carefully considered.Moreover,the long-term safety and impact on oncologic outcomes remain to be elucidated.This review aims to provide a comprehensive overview of the current status,controversies,and recent advancements in the use of intestinal stents for the treatment of obstructive colorectal cancer,with the goalof informing clinical research and practice.
论著

血清乳酸脱氢酶在中晚期肝细胞癌靶向及免疫治疗中的预后预测价值研究

The prognostic value of serum lactate dehydrogenase level as a predictor of prognosis in targeted therapy and immunotherapy for advanced hepatocellular carcinoma

:446-452
 
      目的 探讨血清乳酸脱氢酶(LDH)在中晚期肝癌患者接受靶向联合免疫治疗后的预后预测价值。方法 选取2022年1月—2024年8月在莆田学院附属医院肿瘤内科经病理和影像学检查确诊的中晚期肝癌患者作为研究对象。从医院的电子病历系统中收集患者的基线资料,随访截止2025年8月,并记录随访结果,包括患者的疾病缓解情况和死亡情况,以及无疾病进展生存期(PFS)、总生存期(OS)。采用Kaplan-Meier方法绘制不同基线LDH水平患者的OS生存曲线,并通过Log-rank检验比较生存曲线。同时,运用多因素Cox比例风险回归分析探讨影响中晚期肝癌患者在接受靶向联合免疫治疗后OS的相关因素。结果 结果显示,在50例肝癌患者中,基线LDH低于200 U/L的有15例,而高于200 U/L的有35例。与基线LDH<200 U/L组相比,基线 LDH≥200 U/L患者PFS、OS更短,差异均有统计学意义(χ2分别为5.51、15.6,P值分别为0.019、0.017)。治疗8周后,与LDH降低患者相比,LDH升高患者OS更短,差异有统计学意义(χ2=13.2,P=0.04)。多因素Cox比例风险回归分析结果表明,基线LDH水平超过200 U/L是中晚期肝癌患者接受靶向联合免疫治疗后OS的影响因素[P=0.035,HR(95%CI)=5.03(1.12,22.54)]。结论 基线LDH水平较低的患者表现出更好的OS。基线LDH水平可以作为预测中晚期肝癌患者在接受靶向联合免疫治疗时预后的指标。 
   Objective To evaluate the prognostic significance of serum lactate dehydrogenase(LDH)levels in patients with advanced hepatocellular carcinoma(HCC)undergoing targeted therapy combined immunotherapy.Methods Patients diagnosed with advanced HCC were selected in Putian College Affiliated Hospital from January 2022 to August 2024,diagnosed with pathological and imaging examinations results.Patient baseline data were collected from the hospital’s electronic medical records,with follow-up extending until August 2025.We documented outcomes such as disease response and mortality,along with progression-free survival(PFS)and overall survival(OS).Kaplan-Meier survival curves were constructed based on baseline LDH levels,and the Log-rank test was employed for comparison.Additionally,multivariate Cox proportional hazards regression analysis was conducted to identify factors influencing OS in patients receiving targeted therapy combined immunotherapy.Results Among the 50 patients,15 had baseline LDH levels below 200 U/L,while 35 had levels above.Patients with baseline LDH≥200 U/L had significantly shorter PFS and OS than those with baseline LDH <200 U/L(χ2=5.51 and 15.6 for PFS and OS,respectively;P=0.019 and 0.017,respectively).After 8 weeks of treatment,patients with increased LDH had significantly shorter OS compared with patients with decreased LDH(χ2=13.2,P=0.04).Multivariate Cox proportional hazards regression analysis indicated that a baseline LDH level exceeding 200 U/L is an independent prognostic factor for OS in patients with intermediate to advanced HCC receiving targeted therapy combined with immunotherapy(P=0.035,HR 5.03[1.12,22.54]).Conclusions Patients with lower baseline LDH levels demonstrated better OS,suggesting that baseline LDH can serve as an important prognostic indicator for advanced HCC patients undergoing targeted combined immunotherapy.
论著

腹腔镜结直肠癌根治术患者术前静脉注射艾司氯胺酮的临床效果观察

Clinical observation of preoperative intravenous injection of esketamine in patients undergoing laparoscopic radical resection for colorectal cancer

:466-471
 
      目的 探讨术前静注艾司氯胺酮在腹腔镜结直肠癌根治术患者中的应用效果。方法 前瞻性分析2024年1月—2025年4月在厦门市中医院行腹腔镜结直肠癌根治术患者的临床资料,根据随机数字表法将患者分为两组:对照组40例,术前5 min予5 mL生理盐水;观察组40例,术前5 min予以0.25 mg/kg艾司氯胺酮(以生理盐水配置成5 mL)。比较围术期指标、炎症因子、负性情绪、疼痛情况、不良反应。结果 观察组的手术时间、麻醉时间、术中出血量分别为(213.54±64.22)min、(240.67±81.26)min、(141.31±45.03)mL,与对照组的(210.43±65.71)min、(244.25±81.33)min、(137.64±42.75)mL比较,差异均无统计学意义(t=0.214、0.197、0.374,P均>0.05),而观察组丙泊酚、瑞芬太尼用量分别为(1 075.52±134.37)mg、(1 267.18±242.26)μg,虽然低于对照组的(1?126.64±150.21)mg、(1 352.50±295.14)μg,但差异也无统计学意义(t=1.604、1.413,P均>0.05);观察组在术后24 h的肿瘤坏死因子-α、白介素-6、C反应蛋白水平分别为(54.52±9.64)pg/mL、(40.08±7.75)pg/mL、(30.38±6.93)mg/L,均低于对照组的(77.31±10.86)pg/mL、(56.35±9.47)pg/mL、(43.73±7.61)mg/L(t=9.926、8.409、8.203,P均<0.05);术后1 d的焦虑、抑郁自评量表评分及术后1 h、6 h、12 h、24 h咳嗽时的疼痛视觉模拟量表评分分别为(51.92±4.41)分、(53.96±4.47)分、(3.59±1.14)分、(3.06±1.01)分、(2.89±0.91)分、(2.57±0.76)分,均低于对照组的(55.06±5.12)分、(57.21±5.19)分、(4.27±1.36)分、(3.68±1.18)分、(3.41±1.06)分、(2.96±0.92)分(t=2.939、3.001、2.423、2.525、2.329、2.067,P均<0.05),但两组术后48 h咳嗽时疼痛视觉模拟量表评分比较差异无统计学意义(P>0.05);两组术后不良反应发生率也无显著差异(P<0.05)。结论 在腹腔镜结直肠癌根治术术前静注艾司氯胺酮可有效降低术后炎症反应水平,减轻术后疼痛,缓解术后负性情绪,且不会增加患者术后不良反应发生率。

Objective To explore the application effect of preoperative intravenous injection of esketamine in patients undergoing laproscopic radical resection of colorectal cancer.Methods The clinical data of patient who underwent laparoscopic radical resection of colorectal cancer in Xiamen Hospital of Traditional Chinese Medicine from January 2024 to April 2025 were retrospectively analyzed.The patients were divided into two groups according to the random number table method:40 cases in the control group were given 5 mL saline,five minutes before operation,40 cases in the observation group were treated with 0.25 mg / kg esketamine(in 5 mL saline)five minutes before operation.The perioperative indicators,inflammatory factors,negative emotions,pain and adverse reactions were compared between two groups.Results The operation time,anesthesia time and intraoperative blood loss of the observation group were(213.54±64.22)min,(240.67±81.26)min and(141.31±45.03)mL,respectively,which were not significantly different from those of the control group(210.43±65.71)min,(244.25±81.33)min and(137.64±42.75)mL(t=0.214,0.197,0.374,all P>0.05).The dosage of propofol and remifentanil in the observation group were(1 075.52±134.37)mg and(1 267.18±242.26)μg,respectively,which were lower than those in the control group of (1126.64±150.21)mg and(1352.50±295.14)μg,but the difference was not statistically significant(t=1.604,1.413,P>0.05).The levels of tumor necrosis factor-α,interleukin-6 and C-reactive protein in the observation group at 24 h after operation were(54.52±9.64)pg / mL,(40.08±7.75)pg / mL and(30.38±6.93)mg / L,respectively,which were lower than those in the control group of (77.31±10.86)pg / ml,(56.35±9.47)pg / mL and 43.73±7.61)mg / L(t=9.926,8.409,8.203,all P<0.05).The scores of Anxiety and Depression Self-Rating Scale at 1 day after operation and the scores of pain visual analogue scale at 1 h,6 h,12 h and 24 h after operation were(51.92±4.41),(53.96±4.47),(3.59±1.14),(3.06±1.01),(2.89±0.91) and(2.57±0.76),respectively,which were lower than those of the control group(55.06±5.12),(57.21±5.19),(4.27±1.36),(3.68±1.18),(3.41±1.06) and(2.96±0.92)(t=2.939,3.001,2.423,2.525,2.329,2.067,P<0.05).However,no significant difference was observed in cough-related VAS scores between the groups at 48 h postoperatively(P>0.05).Adverse event rates showed no significance in two groups(P>0.05).Conclusions Preoperative administration of esketamine in laparoscopic colorectal cancer surgery can attenuate postoperative inflammation,decrease pain,mitigate negative emotions,without increasing the incidence of postoperative adverse reactions.
论著

炎症-免疫-营养指标对胃癌腹膜转移的预测模型

A prediction model for peritoneal metastasis of gastric cancer based on inflammatory,immune,and nutritional indicators

:554-562
 
       目的 评估使用炎症、免疫及营养指标对于胃癌根治术后发生腹膜转移的预测作用,并建立适用于术前风险评估的预测模型。方法 回顾性收集2022—2024年苏州市立医院85例晚期胃癌患者的临床资料,按术后是否发生腹膜转移分为转移组44例与非转移组41例。通过分析比较两组间的营养参数[血清白蛋白、纤维蛋白原及预后营养指数(PNI)]、炎症指标[中性粒细胞计数、C反应蛋白、中性粒细胞与淋巴细胞比值(NLR)及全身免疫炎症指数(SII)]、肿瘤标志物以及免疫功能指标(淋巴细胞计数、IL-2、IL-6、TNF-α和IFN-γ)等。使用单因素及多因素Logistic回归分析确定独立预测因子,并构建预测模型,采用Bootstrap法内部验证,计算校正后的曲线下面积及收缩因子,以优化模型性能。结果 多因素分析结果显示,IL-6(OR=1.116,95%CI:1.020~1.224)与CA125(OR=1.016,95%CI:1.006~1.026)为术后腹膜转移的独立预测因素,构建的预测模型区分能力良好,初始AUC为0.801(95%CI:0.702~0.900),经Bootstrap校正后AUC为0.797,模型校准度理想,具有良好的临床稳健性。结论 基于术前IL-6和CA125水平的预测模型,可用于评估胃癌患者根治术后发生腹膜转移的风险。该模型可在术前阶段有效识别高风险病例,为临床制定个体化辅助治疗方案及随访策略提供关键参考,并具有改善患者预后的潜在价值。

       Objective To evaluate the predictive value of inflammatory,immune,and nutritional indicators for peritoneal metastasis after radical gastrectomy in gastric cancer and to establish a predictive model applicable for preoperative risk assessment.Methods Clinical data from 85 patients with advanced gastric cancer treated at Suzhou Municipal Hospital between 2022 and 2024 were retrospectively collected.Patients were divided into two groups based on postoperative peritoneal metastasis occurrence:a metastasis group(n=44)and a non-metastasis group(n=41).Indicators analyzed and compared between groups included nutritional parameters(serum albumin,fibrinogen,PNI),inflammatory markers(neutrophil count,CRP,NLR,SII),tumor markers and immune indicators(lymphocyte count,IL-2,IL-6,TNF-α,IFN-γ).Univariate and multivariate logistic regression analyses identified independent predictors for constructing the prediction model.Internal validation was performed using 1 000 bootstrap resamples to calculate the adjusted area under the curve(AUC)and shrinkage factor for model optimization.Results Multivariate analysis identified IL-6(OR=1.116,95%CI:1.020-1.224)and CA125(OR=1.016,95%CI:1.006-1.026) as independent predictors of postoperative peritoneal metastasis.The constructed predictive model demonstrated good discriminatory ability,with an initial AUC of 0.801(95%CI:0.702–0.900)and a bootstrap-corrected AUC of 0.797.The model exhibited ideal calibration and good clinical robustness.Conclusions This study established a predictive model based on preoperative IL-6 and CA125 levels to assess the risk of peritoneal metastasis after radical surgery in gastric cancer patients.The model effectively identifies high-risk cases preoperatively,providing critical guidance for developing individualized adjuvant treatment and follow-up strategies,with potential to improve patient prognosis.
专家述评

细胞外囊泡来源异质性在乳腺癌转移中的机制及临床转化潜力

Research progress on heterogeneity of extracellular vesicle origins,metastatic mechanisms and clinical translational potential in breast cancer

:798-810
 
       乳腺癌(BC)发病率持续上升,已成为严重威胁公共健康的重大挑战,转移仍是导致患者死亡的主要原因。目前,切除肿瘤并辅以放化疗后仍有较大几率发生转移。此外,早期转移隐匿性强,干预措施不完善及耐药发生迅速均是预后不良的重要因素。细胞外囊泡(EVs)是由细胞释放的、具有膜结构的纳米级颗粒,是细胞间通讯的重要介质。EVs通过转运膜性组分、胞质蛋白及核酸等,调控乳腺癌的发生、进展及转移定植,其来源异质性决定了其在乳腺癌转移中发挥独特作用。本文重点总结了不同来源EVs作为液体活检标志物在转移预警中的价值,以及靶向EVs分泌或阻断其通讯网络在克服免疫治疗耐药中的潜在临床应用,以期为临床医生提供有价值的诊疗参考。
     The incidence of breast cancer(BC) continues to rise and has become a major public health challenge.Metastasis remains the principal cause of BC-related mortality.Currently,there remains a high probability of metastasis even after surgical tumor resection followed by radiotherapy and chemotherapy.The insidious nature of early metastasis,inadequate intervention strategies,and rapid development of drug resistance are all critical factors contributing to poor prognosis.Extracellular vesicles(EVs) are membrane-enclosed,nanoscale particles released by cells.As mediators of intercellular communication,EVs transfer membrane components,cytosolic proteins,and nucleic acids to recipient cells,thereby modulating BC initiation,progression,and metastatic dissemination.The heterogeneity of EV origins determines their distinct roles in breast cancer metastasis.This review focuses on summarizing the value of EVs from different sources as liquid biopsy biomarkers for metastasis warning,as well as their potential clinical applications in targeting EV secretion or blocking their communication networks to overcome immunotherapy resistance,aiming to provide valuable diagnostic and therapeutic references for clinicians.

综述

肺癌患者术后肺功能预测模型的研究进展

Research progress on predictive models of postoperative lung function in patients with lung cancer

:717-723
 
       肺癌作为全球恶性肿瘤中发病率和死亡率较高的一种,手术是其主要治疗手段。然而,肺切除手术常引起肺功能下降,影响患者术后功能恢复及生活质量。准确预测术后肺功能对制定个体化手术方案、降低并发症风险及改善患者预后具有重要意义。目前,研究者已开发出多种结合临床指标、影像学参数及生物标志物的预测模型,用于评估肺癌患者术后肺功能变化。然而,现有模型在准确性、特异性、标准化及临床推广方面仍存在诸多挑战。本文系统综述肺癌术后肺功能的影响因素,并对现有预测模型进行总结与评价,以期为患者术前评估、手术方案选择及术后管理提供参考,进而为改善治疗效果与患者生活质量提供理论依据。

       Lung cancer is a kind of malignant tumor with high morbidity and mortality in the world,and surgery is the main treatment.However,pneumonectomy is often accompanied by the loss of lung function,which seriously affects the recovery of lung function and the  quality of life.Accurate prediction of postoperative pulmonary function is of great significance for formulating individualized surgical plans,reducing the risk of complications and improving the prognosis of patients.At present,researchers have developed a variety of predictive models that combine clinical indicators,imaging parameters,and biomarkers to evaluate postoperative lung function changes in patients with lung cancer.However,there are still many challenges in the accuracy,specificity,standardization and clinical promotion of existing models.This paper systematically reviews the influencing factors of lung function after lung cancer surgery,and summarizes and evaluates the existing prediction models,in order to provide a reference for preoperative evaluation,surgical plan selection and postoperative management of patients,and then provide theoretical basis for improving treatment effect and quality of life of patients.

论著

个性化营养干预联合分级步行运动方案对肺癌化疗患者癌因性疲乏及生活质量的影响

Effects of personalized nutritional intervention combined with graded walking exercise treatment on cancer-related fatigue and quality of life in lung cancer patients during chemotherapy

:367-372
 
       目的  分析对肺癌化学治疗(化疗)患者采取个性化营养干预联合分级步行运动方案的应用价值。   将郑州大学附属郑州中心医院2023年7月—2024年7月符合标准的198例肺癌化疗患者作为研究对象,通过随机数字表法分为观察组和对照组各99例。对照组仅采用个性化营养干预方案,观察组则联合分级步行运动方案,两组患者均在同一时间内入组并接受持续干预3个月。对两组干预前后癌因性疲乏[Piper疲乏修订量表(PFS-R)]、营养状况、睡眠质量[匹茨堡睡眠质量指数(PSQI)]、生活质量[生活质量评估量表(SF-36)]水平予以比较。结果  相较于对照组,干预后观察组PFS-R、PSQI评分较低,白蛋白、前白蛋白、血红蛋白、铁转蛋白水平和SF-36评分较高(P<0.05)。结论  对肺癌化疗患者采取个性化营养干预联合分级步行运动方案,有利于促进其癌因性疲乏的减轻和营养状态、睡眠质量及生活质量水平的提高。
       Objective  To analyze the effects of personalized nutritional intervention combined with graded walking exercise treatment on cancer-related fatigue and quality of life in lung cancer patients during chemotherapy.Methods  A total of 198 lung cancer patients undergoing chemotherapy who met the criteria in our hospital from July 2023 to July 2024 were selected as the research subjects.They were divided into an observation group and a control group,with 99 cases in each group,by the random number table method.The control group only received individualized nutritional intervention,while the observation group received graded walking exercise additionally.Both groups of patients were enrolled at the same time and received continuous intervention for three months.Cancer-related fatigue(Piper’s Fatigue Scale-Revised[PFS-R]),nutritional status,sleep quality(Pittsburgh Sleep Quality Index[PSQI]),and quality of life(Quality of Life Scale[SF-36]) before and after the intervention were compared between the two groups.Results  Compared with the control group,the observation group had lower PFS-R and PSQI scores and higher albumin,prealbumin,hemoglobin,transferrin levels and SF-36 scores after the intervention(P<0.05).Conclusions  Adopting personalized nutritional intervention combined with graded walking exercise for lung cancer patients during chemotherapy is beneficial to promote the reduction of cancer-caused fatigue and the improvement of their nutritional status,sleep quality and quality of life.
论著

TAP 水平与乳腺癌分子分型、临床病理特征的相关性分析

Relationship between TAP level and molecular typing and clinicopathological features of breast cancer

:359-366
 
       目的  探讨TAP水平与乳腺癌分子亚型及临床病理参数之间的相关性。方法  以2021年3月—2025年1月期间收治的150例乳腺癌病例为样本,采用静脉采血方式测定TAP凝聚物表面积指标,通过免疫组织化学EnVision双步染色技术,对雌激素受体(ER)、雄激素受体(AR)、孕激素受体(PR)、Ki-67及p53等表达水平进行分析,采用荧光原位杂交(FISH)对人表皮生长因子受体2(HER2)基因扩增状态进行检测。结果  150例患者中,TAP强阳性131例,TAP弱阳性15例,TAP阴性4例,TAP阳性率97.33%。免疫表型:ER阴性43例,ER阳性107例;AR阳性133例,AR阴性17例;PR阴性60例,PR阳性90例;p53阳性73例,p53阴性77例;HER2强阳性41例,HER2弱阳性89例,HER2阴性20例;Ki-67增殖指数≥20% 116例,Ki-67增殖指数<20% 34例。FISH对65例免疫组织化学检测结果为HER2(2+ )的乳腺癌病例进行基因扩增状态分析,其中阳性7例,阴性58例。Ki-67高增殖组TAP表达水平显著高于低增殖组(P<0.05);不同临床分期患者TAP表达水平存在差异(P<0.05);三阴型、HER2阳性型、Luminal A型和Luminal B型的患者之间的TAP表达水平存在差异(P<0.05),各分子分型(HER2阳性型、三阴型、Luminal A型和Luminal B型)与其对应非分型组的TAP表达均无统计学差异(均P>0.05)。结论  TAP在乳腺癌中广泛表达,且与Ki-67增殖指数、临床分期呈正相关。虽然不同分子分型间TAP表达存在总体差异,但具体亚型对比未显示显著性,后期需扩大样本量验证。
       Objective  To explore the relationship between tumor abnormal protein(TAP)level and molecular typing and clinicopathological features of breast cancer.Methods  A total of 150 breast cancer cases admitted from March 2021 to January 2025 were enrolled in this study.The surface area of TAP condensates was measured using venous blood samples.The expression levels of estrogen receptor(ER),androgen receptor(AR),progesterone receptor(PR),Ki-67,and P53 were analyzed via immunohistochemistry(IHC)using the EnVision two-step staining technique.The amplification status of the human epidermal growth factor receptor 2(HER2+)gene was determined using fluorescence in situ hybridization(FISH).Results  Among 150 patients,131 cases were strongly positive,15 cases were weakly positive and 4 cases were negative,with a positive rate of 97.33%.Immunophenotype:ER positive in 107 cases and ER negative in 43 cases,133 cases were  positive for AR and  17 cases were negative,PR was positive in 90 cases and negative in 60 cases,73 cases were positive for p53 and 77 cases were negative.HER2 is strongly positive in 41 cases,weakly positive in 89 cases and negative in 20 cases.There were 116 cases with Ki-67 proliferation index ≥ 20% and 34 cases with Ki-67 proliferation index < 20%.Sixty-five cases of breast cancer HER2(2 )were detected in the later stage.by FISH,of which 7 cases were positive and 58 cases were negative.The expression level of TAP in patients with high Ki-67 proliferation index was higher than that in patients with low Ki-67 proliferation index(P<0.05).The expression level of TAP in patients with different clinical stages was different(P<0.05).There were differences in TAP expression levels among patients with triple negative type,HER2 positive type,Luminal A type and Luminal B type(P<0.05).There was no statistical difference in TAP expression between each molecular type(triple negative type,HER2 positive type,Luminal A type and Luminal B type)and its corresponding non-typing group(all P>0.05).Conclusions  TAP is widely expressed in breast cancer,and it is positively correlated with Ki-67 proliferation index and clinical stage.Although there is a general difference in TAP expression among different molecular typing,the comparison of specific subtypes shows no significance,and it needs to be verified by expanding the sample size 
论著

补肾益气方肾俞膏摩治疗结直肠癌康复期癌因性疲乏的临床观察及疗效评价:一项随机对照试验

Clinical observation and curative effect evaluation of Shenshu Tuina combined with Bushen Yiqi herbal ointment on cancer-induced fatigue in convalescent stage of colorectal cancer

:333-340
 
       目的  观察补肾益气方肾俞膏摩治疗结直肠癌康复期癌因性疲乏的临床疗效。方法  收集2023年6月—2024年6月结直肠癌康复期的80例住院及门诊患者,随机平均分为两组。行常规对症支持治疗的为对照组;在常规对症支持治疗上加用补肾益气方肾俞膏摩的为干预组;两组均连续治疗14天。于开始治疗前1天和治疗结束后1天分别进行疗效评估相关指标检测。于治疗前1天、治疗第7天和第14天进行不良反应检测。结果 干预组治疗后Piper评分、中医证候总积分、PSQI评分、KPS评分及免疫功能指标(CD3+  、CD4+、CD8+  、CD4+ /CD8+ )较治疗前均有明显改善;干预组发生不良反应少于对照组。结论  补肾益气方肾俞膏摩治疗能够有效改善结直肠癌患者的癌因性疲乏的治疗效果,提高生活质量和免疫功能,减少不良反应。
       Objective  To observe the clinical observation of Shenshu Tuina combined with Bushen Yiqi herbal ointment in the treatment of cancer-induced fatigue in the convalescent stage of colorectal cancer and evaluate the efficacy.Methods  From June 2023 to June 2025,80 inpatients and outpatients of colorectal cancer in the  recovery period were collected and  randomly divided into two groups.The patients who received routine symptomatic supportive treatment were enrolled as the control group.The intervention group was given Shenshu Tuina combined with Bushen Yiqi herbal ointment on the basis of control group.The relevant indicators for efficacy evaluation were tested one day before treatment and one day after the end of treatment.Adverse reactions were detected on the day before treatment,theseventh day and 14th day during treatment.Results  The efficacy evaluation indexes of the intervention group after treatment were obviously improved compared with those before treatment.Adverse  reactions occurred less in the intervention group than in the control group.Conclusions  Shenshu Tuina combined with Bushen Yiqi herbal ointment can effectively improve the treatment effect of cancer-induced fatigue in patients with colorectal cancer,improve the quality of life and immune function,reduce adverse reactions.
论著

肺癌根治术后患者康复期症状体验及心理感受的质性研究

Qualitative study on the symptom experience and psychological feelings of patients after radical resection of lung cancer during the rehabilitation period

:159-164
 
      目的 探讨肺癌根治术后患者康复期的症状体验与心理感受, 为完善症状管理和制定个性化康复干预方案提供依据。方法 采用现象学研究法,对15例肺癌根治术后康复期患者进行半结构式访谈, 运用Colaizzi 7步分析法进行归纳和提炼主题。结果 归纳出5个主题, 12个亚主题:多重躯体症状负担持续存在(术后疼痛综合征、顽固性刺激性咳嗽、劳力性呼吸困难、持续性疲劳感); 负性心理情绪困扰(病耻感、疾病不确定感与复发恐惧); 心理调适过程(诊断冲击与认知失调、角色适应与主动应对); 创伤后成长与健康行为转变(生命意义感提升、健康促进行为强化); 强烈的康复信息支持需求(自我保健知识需求、结构化康复锻炼指导需求)。结论 医护人员应关注肺癌根治术后患者康复期的症状体验, 动态评估患者的身心状况, 制定精准、有效的个性化干预方案, 帮助患者树立康复信心, 改善术后康复体验和提高生活质量。
       Objective  To explore the symptom experience and psychological feelings of patients during the rehabilitation period after radical resection of lung cancer, aiming to provide a basis for improving symptom management and formulating personalized rehabilitation interventions.Methods The phenomenological research method was used to conduct semi-structured interviews with 15 patients in the rehabilitation period after radical surgery for lung cancer.Colaizzi's 7-step analysis method was used to summarize and extract themes.Results Five themes and 12 sub-themes were summarized:Persistent burden of multiple physical symptoms(postoperative pain syndrome, refractory irritative cough, exertional dyspnea, persistent fatigue); negative emotional experiences(stigma of illness, illness uncertainty and fear of recurrence); psychological adjustment processes(diagnostic shock and denial, role acceptance and active coping); post-traumatic growth and health behavior transformation(enhanced sense of meaning in life, strengthened health-promoting behaviors); strong demand for rehabilitation information support(self-care knowledge, rehabilitation exercise knowledge).Conclusions Medical staff should pay attention to the symptom experience of patients during the recovery period after radical lung cancer surgery, dynamically assess their physical and mental conditions, develop precise and effective personalized intervention plans, help patients build confidence in recovery, and thereby improve their postoperative rehabilitation experience and quality of life.
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