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Objective:To explore the effect of motivational interview combined with feedback teaching on active cycle of breathing technique(ACBT) training in lung cancer patients.Methods:A total of 632 patients with lung cancer undergoing radical resection from September 2017 to March 2019 in Sun Yat-sen University Cancer Center were selected and divided into the experimental group and the control group with 316 cases in each group by operation time. The experimental group received motivational interview combined with feedback teaching education, while the control group received routine education. The patients were followed up for 2 months. The compliance and accuracy of ACBT training, self-care ability, sputum discharge and incidence of pulmonary complications were compared between the two groups.Results:The sputum volume in the control group was (6.25±2.44), (9.28±2.63), (10.33±3.15) g in the control group and (8.74±4.17),(13.87±3.19),(14.18±4.16) g in the experimental group at 1, 2, 3 days after operation, and the differences between the two groups were statistically significant ( t values were -1.149, -2.316, -4.124, P<0.01 or 0.05). There were 56 cases(17.72%) of pulmonary complications in the control group and 33 cases (10.44%) in the experimental group. The difference in the incidence of pulmonary complications between the two groups was statistically significant ( χ2 value was 4.743, P<0.01).Two months after operation, the compliance and accuracy of ACBT training in the experimental group were better than those in the control group ( χ2 values were - 4.57, - 2.15, P<0.01).The improvement in the four dimensions after intervention in the experimental group were better than those in the control group, and the differences were statistically significant ( t values were 8.314-19.719, P<0.01). Conclusions:The motivational interview combined with feedback teaching is an effective method of health education, which is conducive to improving lung cancer patients' compliance and accuracy of postoperative ACBT training, improving patients' self-care ability, promoting the discharge of patients' sputum and reducing the incidence of pulmonary complications to promote the recovery of lung function.
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<p><b>OBJECTIVE</b>To investigate the risk factor for metastasis in Level IV of ipsilateral neck in tongue cancer patients.</p><p><b>METHODS</b>A total of 248 tongue caner paitents (255 necks) that underwent radical neck dissection was enrolled in the study. Chi-square test and Logistic regression analysis were used to determine the factors associated with metastasis in Level IV. The variable included age, sex, growth type, T stage, histopathological grade, Level III involvement, number of positive lymph nodes in Levels I-III.</p><p><b>RESULTS</b>Out of 147 cases (152 necks) with positive lymph node, 21 necks (8.2%, 21/255) had Level III involvement, and 2 necks (0.8%, 2/255) developed skip metastasis. Chi-square test showed that age (P = 0.020), Level III involvement (P = 0.000), number of positive Level (≥ 2 Levels) in Levels I-III (P = 0.006), and number of positive lymph node (≥ 3 nodes) in Levels I-III (P = 0.000) were identified as independent risk factor. Logistic regression analysis revealed that only Level III involvement (P = 0.003) was the risk factor for metastasis in Level IV.</p><p><b>CONCLUSIONS</b>In tongue cancer patients, Level III involvement was a high risk factor for metastasis in Level IV.</p>
Subject(s)
Female , Humans , Male , Age Factors , Carcinoma, Squamous Cell , Chi-Square Distribution , Lymph Nodes , Pathology , Lymphatic Metastasis , Neck , Neck Dissection , Regression Analysis , Risk Factors , Sex Factors , Tongue Neoplasms , PathologyABSTRACT
Objective:To investigate the Level Ⅳ metastasis risk factor of oral cancer patient's ipsilateral neck. Methods:The medical records of 624 cases (644 sides of the neck) that underwent neck dissection at the time of primary surgery for oral carcinoma were included. Chi-square test and logistic regression analysis were performed to determine the factors associated with LevelⅣmetas-tasis. Results:Out of 334 cases (345 neck sides) with positive lymph nodes, only 35 sides (5.43%, 35/644) showed LevelⅢinvolve-ment and only 4 sides (0.62%, 4/644) developed skip metastasis (LevelⅢ). The metastatic rate of LevelⅣwas 1.31%(4/303) for pN-LevelsⅠ-Ⅲnecks and 9.14%(31/341) for pN+LevelsⅠ-Ⅲnecks. Using Chi-square test, pN+LevelsⅠ-Ⅲlymph node metastases were associated with the LevelⅣnodal metastases. For necks with pN+LevelⅢ, with three positive Levels among LevelsⅠ-Ⅲ, and with positive lymph node≥3 among LevelsⅠ-Ⅲ, the LevelⅣmetastasis rates were 22.47%(20/89), 28.57%(10/35), and 14.60%(20/137), respectively. Furthermore, logistic regression was applied to identify the relationship between the metastasis situation of the afore-mentioned three Levels and LevelⅣ. Three positive Levels among LevelsⅠ-Ⅲ(pN+LevelⅠ+pN+LevelⅡ+pN+LevelⅢ) were confirmed to correlate with the presence of the positive lymph nodes in LevelⅣ. Conclusion:In oral cancer patients, LevelsⅠ-Ⅲmetastaces will increase the risk of LevelⅣmetastasis.
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Objective:To analyze the predilection of metastasis at levels Ⅰ,Ⅱ,Ⅲ, Ⅳ,Ⅴfor oral and maxillary squamous cell carcinoma on different primary sites .Methods: A retrospective review was conducted of the records of 1 233 patients ( 1 340 necks ) from January 2000 to December 2011 with squamous cell carcinoma simultaneously underwent primary tumor resection and neck dissection in De -partment of Oral and Maxillary Surgery , Peking University School and Hospital of Stomatology .The to-pography of positive neck node was recorded , and the calculation was performed for the metastasis rate of levels Ⅰ,Ⅱ,Ⅲ,Ⅳ,Ⅴbased on the primary site , respectively .Results:There were 557 necks with positive node (41.57%), and the metastasis rate for level Ⅰ, Ⅱ, Ⅲ, Ⅳ, and Ⅴ were 27.61%, 22.91%, 9.18%, 4.99%, 3.24%, respectively.Those in level Ⅲ were at high risk for metastasis from carcinoma of tongue and the floor of mouth .The positive rate in level Ⅱwas more than that in levelⅠfor tongue carcinoma , but for inferior gingiva carcinoma , bucca carcinoma , upper gingiva carcinoma , palatine carcinoma , maxillary sinuse carcinoma , intraosseous carcinoma of mandibular , the positive node was more likely to happen at level Ⅰcompared with level Ⅱ.Conclusion: Most metastases happen in levels Ⅰ-Ⅲfor patients with oral and maxillary squamous cell carcinoma , but the predilection of metas-tasis in level Ⅰ,ⅡorⅢis varied with the primary sites .