原 著 放射線皮膚炎に対する保湿クリームの効果 耳鼻科領域の頭頸部照射の患者に保湿クリームを使用して * 要旨 Gy Key words はじめに 1 70Gy 2 2 QOL

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1 原 著 放射線皮膚炎に対する保湿クリームの効果 耳鼻科領域の頭頸部照射の患者に保湿クリームを使用して * 要旨 Gy Key words はじめに 1 70Gy 2 2 QOL 連絡先 Phone Fax E mail

2 60Gy 研究目的 研究方法 研究対象者 Gy 5 6MeV X 研究期間 方法と内容 ) 研究デザイン ) 患者指導および説明 ) 保湿クリームの選択 ) 保湿クリームの使用方法

3 g ) データの抽出方法 ( 表 ) CTCAE v 3.0 JCOG/JSCO データの分析方法 1 Mann Whitney U Mann Whitney U StatView ver [ 倫理的配慮 ] [ 用語の定義 ] ) 急性有害事象 ) 乾性落屑 表 皮膚障害の点数化 表 対象者の背景 n 16 n 17 p U Gy1 60Gy Gy1 60Gy3 66Gy4 66Gy4 70Gy10 70Gy U Mann Whitney U 2 p

4 表 使用群と未使用群の照射線量ごとの自覚症状と他覚症状 a. 使用群 Gy Gy b. 未使用群 Gy Gy Gy

5 用群未使用群照射線量使無症状かさつきツッパリ感掻痒感痛痒さ痛い Gy Gy 図 使用群と未使用群の照射線量ごとの自覚症状 ) 湿性落屑 ) びらん 結果 対象者の背景 Gy 10 66Gy 4 60Gy Gy Mann-Whitney U 2 ( 表 )

6 用群未使用群照射線量使無症状 乾性落屑 淡い発赤 湿性落屑 発赤 色素沈着 間擦部以外の湿性落屑 中 ~ 高度発赤 Gy Gy 図 使用群と未使用群の照射線量ごとの他覚症状 保湿剤使用群と未使用群の皮膚障害の比較 1( 表 図 ) Gy 48Gy 60Gy Gy 38Gy 52Gy Gy 8Gy 46Gy Gy 36Gy 64Gy Gy 20Gy 64Gy Gy 58Gy 68Gy Gy 44Gy 66Gy Gy 48Gy 68Gy Gy 52Gy 68Gy ( 表 図 ) Gy 2Gy 16Gy Gy 2Gy 14Gy

7 累積点数 使用群平均 120 未使用群平均 * * * *p< 照射線量 (Gy) Gy p Mann-Whitney U p 0.05 図 照射線量ごとの累積点数 Gy 4Gy 38Gy Gy 4Gy 46Gy Gy 24Gy 60Gy Gy 28Gy 56Gy Gy 48Gy 68Gy Gy 44Gy 66Gy Gy 64Gy 68Gy Gy 48Gy 66Gy Gy 62Gy 66Gy % 55.5Gy 48Gy 66Gy Mann-Whitney U 60Gy 60Gy 67.7vs.88.4 p= Gy 83.9vs p= Gy 94.5vs p=0.013 ( 図 )

8 考察 放射線皮膚炎に対する保湿剤の効果 Gy 44Gy Gy 46Gy Gy 56.4Gy 2.5Gy Gy 3 7.3Gy 脆弱 Gy 66Gy 70Gy

9 放射線皮膚炎に対する看護支援 おわりに 謝 28 辞 結論 文 献 本研究の限界と今後の課題 ganjoho.ncc. go.jp/search?q , , JCOG / JSCO v

10 Abstract The Effect of Moisturizing Cream for Radiation Dermatitis Use the Moisturizing Cream for Patients Undergoing Head and Neck Irradiation by Masae Saito 1, Katsumi Hayashi 2 from 1 Nursing Division, National Defense Medical College Hospital 2 Department of Radiology, National Defense Medical College The purpose of this study is to illustrate the value of moisturizing cream in preventing the acute skin side effects induced by radiotherapy and helps nursing care. Thirty three patients with radiotherapy for head and neck cancer from January 2011 to September 2013 were enrolled with their consent. Patients were ineligible if they had undergone tracheotomy or they had not had whole neck field radiotherapy excluding larynx cancer patients. Using the envelope method, we divided patients into those using moisturizing cream (n=16) those not using cream (n=17). The moisturizing cream was applied gently twice a day, after the radiotherapy treatment and before going to bed. During treatment patients underwent daily subjective and objective assessments. We classified these assessments from 0 to 6 step by step and totaled these scores. We analyzed these scores using a statistical method (Mann Whitney U test). As a result, the patients using moisturizing cream displayed a delay in appearance symptoms and significant lower scores subjective and objective assessment than the patients not using moisturizing cream (60Gy: 67.7 vs p<0.01, 66Gy: 83.9 vs p<0.01, 70Gy: 94.5 vs p<0.05). Using moisturizing cream prevents the worsening of radiation dermatitis and relieves the symptoms induced by radiation dermatitis. Key words radiation dermatitis, undergoing head and neck irradiation, skin care, moisturizing cream Address reprint requests to : Masae Saito. Nursing Division, National Defense Medical College Hospital 3 2 Namiki, Tokorozawa-shi, Saitama , Japan Phone Fax E mail

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