梅志红:疫情之下,NSCLC患者居家康复经验分享、就诊注意事项及心理疏导

2020-03-26 佚名 肿瘤威廉亚洲官网

突如其来的疫情,牵动着williamhill asia 每个人的心,也影响了正常的生活。目前,新冠肺炎的疫情已有所好转,但仍不可松懈。非小细胞肺癌(NSCLC)患者免疫力低,是新冠肺炎的高危易感人群,需要更多照护和关注。

突如其来的疫情,牵动着williamhill asia 每个人的心,也影响了正常的生活。目前,新冠肺炎的疫情已有所好转,但仍不可松懈。非小细胞肺癌(NSCLC)患者免疫力低,是新冠肺炎的高危易感人群,需要更多照护和关注。

给NSCLC患者居家健康管理的四个建议

疫情之下,肿瘤患者是更特殊的群体,属于肺炎易感人群。肺癌患者在家庭健康管理时可以从以下四个方面进行:第一,预防。患者要做到科学防护,不信谣不传谣,正确面对新型冠状病毒。不着急也不恐慌,遵循专家建议,居家隔离,禁止聚会,减少探亲访友等活动。保持室内空气新鲜,定期开窗通风;保持室内温度在20~23℃比较舒适的环境。勤洗手,注意饮食卫生。此外,也要关注家庭成员对疾病的防控。家属外出购物时,配戴口罩和手套;外出回家后洗手脱外衣,换上家居服后再进入患者房间。第二,管理自己的身体。Ⅲ期NSCLC患者病情较重,治疗时间也较长,需要接受包括手术、化疗、放疗和免疫治疗等治疗。患者在居家过程中,最好每周测一次体重。有任何不适可以通过网上问诊平台求助。第三,禁止不良嗜好,包括禁烟限酒,避免吸入二手烟,保持良好的睡眠。第四,情绪管理,做情绪管理的主人。

NSCLC患者的营养管理——饮食多样化,营养均衡摄入,吃动平衡

营养管理要遵循一个原则——饮食多样化,营养均衡摄入。疫情当下,良好的饮食摄入有助于抵抗力的提升。要达到多样化和饮食均衡,就要保持吃动平衡,进而有利于体重管理。NSCLC患者的营养摄入和生活质量有一定相关性。欧洲的一项研究表明,接受一线化疗的NSCLC患者,化疗期间同时口服鱼油可减少体重下降,提高生活质量。

在饮食调节上,要从几个方面进行:进食量,进食时间,进食过程,进食环境和进食方法。首先,进食量。根据中国居民膳食威廉亚洲博彩公司 ,患者在修整期或患病期,没有很强的体力劳动,可以按轻体力劳动计算。50~60岁男性患者每天需要能量摄入量为2050kcal~2100kcal;女性患者每天需要1500kcal~1750kcal。能量的主要提供者是碳水化合物,即米面杂粮等谷物;蛋白质的摄入量,50~65岁男性60g/d,女性50g/d;谷类和杂豆类250~400g/d;蔬菜300~500g/d,水果200~400g/d;畜肉类食物50~70g/d;鱼虾50~100g/d;蛋类25~50g/d;奶制品300g/d;大豆及坚果类30~50g/d。当然,williamhill asia 还要摄入一定的油脂,25~30g/d;盐少于6g/d。

第二,进食时间,可以考虑三顿正餐三顿加餐。早餐最好不要晚于8点吃完,午餐12点,晚餐18点;在三餐之间进行加餐。早餐和午餐之间可以加一些水果、坚果或酸奶;午餐和晚餐之间可以加果汁、蔬菜汁、饼干和面包;睡前可以喝一些牛奶,吃些面包或饼干。

第三,进餐过程,餐前要进行口腔准备。很多化疗患者会有口腔溃疡或口腔异味,可以先用漱口水漱口,溃疡患者可以用口腔溃疡贴让伤口麻木,吃饭时不那么疼,不影响进食。此外,就餐时还要注意着装,不要穿很紧的衣服进食。进餐后要休息1小时。

第四,进食环境。进食环境会影响williamhill asia 的食欲,保持清新的环境,选择瓷器或金属器具。

第五,进食方法。细嚼慢咽、小口少量进食。将食物切割、研磨、研碎才咽下去,让食物在口腔中和唾液有充分的混匀,咽下去才能够更好的消化。小口少量是指一次性进食量不要太大。化疗的患者如果口腔内食物过多会,可能会反射性引起恶心、呕吐。最后关于吃动平衡,即要求适量的运动。运动可增强抵抗力,中国膳食威廉亚洲博彩公司 要求每天不少于6000步。Ⅲ期NSCLC患者体力不是很好,在锻炼时,以不感觉到累为准。疫情期间,可以选择在房间内散步、做广播体操等。

NSCLC患者就诊建议——个人防护,预约就诊,就近治疗

Ⅲ期NSCLC患者需要综合治疗,大多数治疗都需要往返院进行。往返医院的过程中,要做好防护,如佩戴外科口罩或N95口罩,最好不要选择带呼吸阀的口罩。就诊前通过微信或其他网上预约平台挂号,按时前往门诊就诊。就诊过程中也有几点要注意的地方,首先,佩戴口罩进医院。第二,遵循医院门诊限流原则。在候诊过程中选择空旷的地方等候。住院患者在住院期间也一定要全程戴口罩,陪伴家属也是。不要串病房与病友交流。此外,由于道路限行,肿瘤患者尽量就近就医,可以通过网络在线平台咨询上级医院医生,在当地医院进行治疗。

关注Ⅲ期NSCLC的心理健康

不止NSCLC患者,许多肿瘤患者或多或少都有一些心理问题,严重影响患者的生活质量。中国肿瘤心理治疗威廉亚洲博彩公司 推荐了很多干预和管理方法,常用的方法就是深呼吸。患者可以平躺,双膝屈膝,在膝盖窝处垫一个软枕,两手分别放在胸前和腹部,用鼻子缓慢吸气,此时腹部上的手有向上抬起的感觉,而胸部的手则原位不动。呼气时,腹肌收缩,腹部的手有下降的感觉。建议患者每天都进行这一练习,尤其晚期肿瘤患者,呼吸训练可以缓解轻度缺氧,每天坚持锻炼非常必要。每次可以练习5~15分钟,每天训练5~7次。在练习过程中,注意呼吸要深而长,尽量使用鼻子而不使用口。另外,冥想训练也是干预心理问题非常好的手段。患者可以根据自己的情况,放一段舒缓的音乐,找一个舒适的位置,随着音乐冥想。此外,在患者心理干预方面,家属对患者的支持也非常重要。总体而言,我国的新冠肺炎疫情已得到很好的控制,社会也逐渐正常,肿瘤患者的诊疗也将逐步正常。相信通过医护人员的共同努力,疫情终将过去,肿瘤患者的寒冬也将过去。

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    2020-11-06 jklm09
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    2020-03-26 肿肿

    NSCLC下一步突破在于新靶点了,靶向治疗和免疫治疗基本见顶了,再有新的就需要新机制了

    0

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本期「专家组稿」由北京大学肿瘤医院云南医院李高峰教授担任执行主编,与曲靖市第二人民医院心胸外科罗详冲医生共同分享《EGFR基因共突变晚期NSCLC患者一线治疗策略最全总结》,为医者和患者提供更多参考。

郭其森教授组稿|张初峰:三代EGFR/ALK-TKIs的耐药机制及管理策略

本期「专家组稿」由山东省肿瘤医院郭其森教授担任执行主编,与山东省肿瘤医院张初峰博士共同分享《三代EGFR/ALK-TKIs的耐药机制及管理策略》,为医者和患者提供更多参考。