【摘要】 目的 探讨医护一体化管理对抗程序性死亡受体（programmed call death protein 1, PD-1）PD-1后线治疗晚期鼻咽癌患者癌因性疲乏及生活质量的影响。方法 选择2018年1月～2019年12月收治的PD-1治疗一线全身治疗失败的复发转移鼻咽癌（无法手术及放疗）患者68例为研究对象，根据住院时间分为实验组（2018年1～12月）34例，对照组（2019年1-12月）34例。对照组给予由专科护士负责的常规护理干预，实验组实施医护一体化管理模式。随访1年，比较2组患者癌因性疲乏、生命质量指标。结果 管理前，两组患者癌因性疲乏得分差异无统计学意义（P>0.05）；管理后实验组癌因性疲乏得分总分及各维度得分均低于对照组，差异有统计学意义（P<0.05）。管理前，两组患者生命质量得分差异无统计学意义（P>0.05）；管理后实验组生命质量得分高于对照组，差异有统计学意义（P<0.05）。结论 医护一体化管理能有效改善PD-1后线治疗晚期鼻咽癌患者疲乏程度，提升患者生活质量，值得临床推广应用。更多还原

【Abstract】 Objective To investigate the effect of doctor-nurse integrated medical management on cancer-related fatigue(CRF and quality of life in advanced nasopharyngeal carcinoma(NPC)patients undergoing PD-1 inhibitor for subsequent-line therapy.Methods A total of 68 recurrent, unresectable, or metastatic nasopharynx carcinoma patients with no surgery or RT option undergoing PD-1 inhibitor for subsequent-line therapy after failure of first-line therapy from January 2018 to December 2019 were enrolled as subjects. According to the hospitalization time, they were divided into the trial group(January 2018-December 2018, 34 cases) and the control group(January 2019-December 2019, 34 cases). The control group was given routine nursing interventions by specialist nurses,while the trial group implemented the doctor-nurse integrated management model of medical care. After 1 year of follow-up, the indicators of cancer-related fatigue and quality of life were compared between the two groups. Results Before management, there was no statistical difference in the score of CRF between two groups(P>0.05).After management, the total score and dimension scores of CRF of trial group were lower than those of control group with statistical differences(P<0.05).Before management, there was no statistical difference in the score of quality of life between two groups(P>0.05).After management, the total score of quality of life of trial group was higher than that of control group with a statistical differenc(P<0.05). Conclusions Doctor-nurse integrated medical management can effectively improve the fatigue and life quality of advanced nasopharyngeal carcinoma patients undergoing PD-1 inhibitor for subsequent-line therapy, which is worthy of clinical popularization and application.更多还原