主管:国家卫生健康委员会
主办:国家卫生健康委医院管理研究所
中国科技核心期刊(中国科技论文统计源期刊)
中国科学引文数据库(CSCD)核心库期刊
《中文核心期刊要目总览》核心期刊

中国护理管理 ›› 2025, Vol. 25 ›› Issue (4): 499-505.doi: 10.3969/j.issn.1672-1756.2025.04.004

• 特别策划·肿瘤专科护理发展 • 上一篇    下一篇

肺癌患者免疫治疗相关皮肤不良反应的管理方案构建与初步应用

张晓菊 张婷婷 陈凤珍 陆箴琦   

  1. 复旦大学附属肿瘤医院护理部,复旦大学上海医学院肿瘤学系,200032 上海市
  • 出版日期:2025-04-15 发布日期:2025-04-15
  • 通讯作者: 陆箴琦,硕士,主任护师,护理部主任,E-mail:luzhenqi1972@163.com
  • 作者简介:张晓菊,博士,主任护师,护理部副主任
  • 基金资助:
    国家自然科学基金青年科学基金项目(72004031)

Development and preliminary application of a management program in lung cancer patients with immune-related cutaneous adverse events

ZHANG Xiaoju, ZHANG Tingting, CHEN Fengzhen, LU Zhenqi   

  1. Department of Nursing, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
  • Online:2025-04-15 Published:2025-04-15
  • Contact: E-mail:luzhenqi1972@163.com

摘要: 目的:构建肺癌患者免疫治疗相关皮肤不良反应的管理方案并初步应用,为相关临床实践提供参考。方法:2023年2月—5月,结合文献研究和半结构式访谈、专家小组会议构建管理方案。采用便利抽样法,抽取2023年11月在上海市某三级甲等医院行免疫治疗的29例肺癌患者设为对照组,将2023年12月住院的29例患者设为干预组,对照组实施常规护理,干预组实施肺癌免疫治疗相关皮肤不良反应管理方案。比较干预前后两组患者肺癌免疫治疗相关皮肤不良反应发生率、自我护理能力、健康促进生活方式、心理状态。结果:构建的管理方案包括预防管理方案和治疗管理方案。干预后,干预组和对照组肺癌免疫治疗相关皮肤不良反应的发生率分别为31.0%和48.3%,差异无统计学意义(P>0.05);干预后,干预组自我护理能力得分高于对照组,差异具有统计学意义(P<0.05)。结论:肺癌免疫治疗相关皮肤不良反应管理方案具有较好的科学性、可靠性和可行性,初步应用证实了该方案对患者自我护理能力的有效性,为医护人员开展肺癌患者免疫治疗相关皮肤不良反应的预防和管理提供了参考。

关键词: 肺肿瘤;免疫检查点抑制剂;皮肤不良反应;症状管理;方案构建

Abstract: Objective: To develop and preliminarily apply a management program for immune-related cutaneous adverse events in patients with lung cancer, and provide reference for related clinical practice. Methods: From February to May 2023, the first draft of the management plan was developed using literature research and interviews, guided by the modified dynamic symptom model. It was revised after the presentation at an expert meeting. Convenience sampling was employed in the study. Routine care was provided to the participants in the control group who were admitted in November 2023. A management program for immune-related cutaneous adverse events in lung cancer immunotherapy was provided to patients in the intervention group who were admitted in December 2023. Pre- and post-intervention comparisons were made between the two groups on skin reaction incidence, self-care abilities, health-promoting lifestyles, and psychological status. Results: The management program for immune-related cutaneous adverse events in lung cancer patients consisted of two parts including a preventive management program and a therapeutic management program. After the intervention, the incidence of immune-related cutaneous adverse events in lung cancer immunotherapy in the intervention group and control group was 31.0% and 48.3% respectively, with no statistically significant difference (P>0.05). While there were statistically significant differences in self-care ability between the two groups, with higher self-care ability scores in the intervention group (P<0.05). Conclusion: The management program is constructed based on evidence, combining patient needs and expert opinions, and has good scientific validity and reliability, providing a reference for healthcare professionals to carry out the prevention and management of immune-related cutaneous adverse events in lung cancer patients.

Key words: lung neoplasms; immune checkpoint inhibitors; cutaneous adverse events; symptom management; development of program

中图分类号:  R47;R197