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肺癌是目前全球范围内最常见的恶性肿瘤之一,在我国,肺癌是病死率最高的恶性肿瘤,由于多数患者就诊时已处于中晚期,失去了根治性手术切除的机会,只能采用放疗、化疗及生物治疗等保守治疗,总体治疗效果因患者的一般情况及肿瘤分期等而异。放射性粒子植入治疗是一种局部适形内放疗方法,具有靶区高剂量、周围正常组织低剂量的特点[1]。多位学者研究报道了经CT引导下125I粒子植入治疗的中晚期肺癌患者,均取得了非常理想的疗效[2-3]。本文参考了国内外文献及自身的体会,将125I粒子植入治疗中晚期肺癌的护理及辐射防护综述如下。
125I粒子植入治疗非小细胞肺癌的护理及辐射防护
Radiation protective nursing intervene of 125I seed implantation in non-small cell lung cancer
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摘要: 肺癌是最常见的肺部原发性恶性肿瘤,由于多数患者就诊时已处于中晚期,瘤体侵犯重要脏器后常影响肿瘤的切除。125I粒子永久性组织间植入治疗是肿瘤近距离放疗的一种新兴方法,有助于肿瘤的整体杀灭,同时保证了脏器的正常生理功能,减少了组织创伤及治疗并发症,提高了患者的生存率。随着放射性粒子植入治疗技术的迅速推广,治疗过程中的辐射威胁也随之而至。目前,对125I粒子的研究局限于治疗手段和效果方面,尚未在术中使用、消毒及防护等方面进行详细研究。虽然能达到疗效是治疗的关键,但是防护的基本原则、具体方式和更新防护技术的研究也不容忽视,其研究结果势必对肿瘤的放射性粒子植入治疗有着重要意义。Abstract: Lung cancer is the most common primary malignant tumor. Because most sufferers have already been in later stage in their first diagnosis, the lump body infringing upon the important organs often influences the excision of tumor. 125I seeds permanent implantation is a new method for tumor brachytherapy, which contributes to kill the tumor completely, ensures the normal physiological functions of organs, reduces tissue injuries and treatment of complications, and raises the survival rate of sufferers. The rapid promotion of this technique is also followed by radiation risks in the treatment. Currently, the researches of 125I seeds implantation is limited to the aspects of treatment means and effects, with no detailed study in intraoperative usage, disinfection and protection. Although a satisfactory curative effect is the key in the treatment, the studies in protection principles, means and technological upgradation are also too important to be ignored.
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