分析头皮冷却疗法治疗乳腺癌化疗诱导脱发的效果和安全性。

本研究为前瞻性研究。选择2016年10月至2018年5月中国医科大学附属盛京医院乳腺外科收治的124例接受化疗的乳腺癌患者作为研究对象，随机分为对照组和干预组各62例。在化疗期间，对照组患者给予常规化疗护理和治疗，干预组患者在其基础上应用头皮冷却装置进行持续性冷敷，观察头皮冷却疗法的安全性。采用Mann-Whitney U检验比较2组患者完成4个周期化疗后的脱发情况，采用t检验分析2组患者间化疗后身体意象和生命质量评分的差异。

(1)研究过程中，有5例患者因无法耐受化疗不良反应而拒绝继续进行化疗，2例因无法耐受头痛而退出研究。化疗完成后，最终有117例患者纳入分析，其中干预组57例，对照组60例。干预组中有28例1级脱发，29例2级脱发；对照组中有5例1级脱发，55例2级脱发。与对照组相比，干预组脱发情况得到显著改善(Z＝4.880，P<0.001)。(2)应用身体意象量表(BIS)和南丁格尔症状评估量表(N-SAS)对2组患者的身体意象和生命质量进行评估，结果显示：在化疗后，干预组患者身体意象评分为(7.6±5.2)分、社交情况评分为(1.3±1.4)分，而对照组患者身体意象评分为(9.5±5.2)分、社交情况评分为(1.9±1.7)分，2组比较，差异均有统计学意义(t＝-2.039、-2.010，P均<0.050)。(3)头皮冷却治疗的不良反应发生率为29.8%(17/57)，表现为头痛、头皮寒冷、感觉异常、头晕、恶心、寒战，无严重不良反应。

乳腺癌患者在化疗过程中应用头皮冷却装置能有效降低脱发的发生率，并有助于改善患者的身体意象和生命质量，具有临床应用价值。

To analyze the effect and safety of scalp cooling therapy on chemotherapy-induced alopecia in breast cancer patients.

This was a prospective study. Totally 124 breast cancer patients who received chemotherapy in the Department of Breast Surgery, the Shengjing Hospital of China Medical University from October 2016 to May 2018 were enrolled and randomized into the control group and intervention group, 62 patients in each group. During chemotherapy, patients in the control group were given routine care and treatment, while a scalp cooling device was used for continuous cold compress in the patients of intervention group and the safety of this therapy was monitored. The Mann-Whitney U test was used to compare the incidence of hair loss after 4 cycles of chemotherapy between two groups. The t test was used to compare the body image and life quality scores between two groups after the chemotherapy.

(1)During the study, five patients refused to continue chemotherapy because of adverse reactions, and two patients withdrew from the study because of headache. After chemotherapy, 117 patients completed this experiment (57 in the intervention group and 60 in the control group). There were 28 cases of grade 1 hair loss and 29 cases of grade 2 hair loss in the intervention group, 5 and 55 in the control group. The hair loss in the interventional group was significantly improved compared with the control group(Z=4.880, P<0.050). (2)The body image scale (BIS) and Nightingale Symptom Assessment Scale (N-SAS) were used to evaluate the body image and life quality of patients. The results showed that the scores of BIS and N-SAS in the intervention group were significantly lower than those in the control group after chemotherapy (7.6±5.2 vs 9.5±5.2, 1.3±1.4 vs 1.9±1.7, t=-2.039, -2.010, both P<0.050). (3)The incidence of adverse reactions was 29.8%(17/57). The patients reported headache, coldness in scalp, paresthesia, dizziness, nausea and chills. There were no serious adverse reactions.

In breast cancer patients undergoing chemotherapy, the scalp cooling device can effectively reduce the incidence of hair loss and improve the body image and quality of life, worthy of clinical application.