Abstract: Background　The massive exudation，odor，and pain of malignant fungating wounds can cause physical and psychological pain to patients.Objective　To investigate the effect of symptom intervention combined with spiritual care on malignant fungating wound.Methods　A total of 59 patients with malignant fungating wound in Outpatient Dressing Room，the Fourth Hospital of Hebei Medical University were selected from December 2015 to December 2017.By combining healing and palliative care ，malignant fungating wound was treated with symptom intervention and spiritual care.Pain level，degree of exudation，and odor level were measured and quality of life was evaluated by WHO Quality of Life-BREF （WHOQOL-BREF） before and after 2 and 4 weeks of intervention.Results　There were significant differences in Numerical Rating Scale （NRS） score，exudation degree，odor level，scores of physiology field （PHYS），psychological field （PSYCH），independence field （IND），social relation field （SOCIL），environment field （ENVIR），and spiritual pillar/religion/personal belief （DOM6） before and after intervention （P<0.05）；2 weeks after intervention，exudation degree and odor level were lower than those before intervention，and scores of PHYS，PSYCH，IND，ENVIR，and DOM6 were higher than those before intervention； 4 weeks after intervention，NRS score，exudation degree，and odor level were lower than those before and 2 weeks after intervention，and scores of PHYS，PSYCH，IND，SOCIL，ENVIR，DOM6 were higher than those before and 2 weeks after intervention（P<0.05）.Conclusion　Symptom intervention combined with spiritual care has a good effect on malignant fungating wound，which can improve patients' somatic symptoms，so as to improve their quality of life，and comfort their minds.Therefore，it is worthy of clinical popularization.

Key words: Neoplasms, Mushroom-shaped wounds, Symptom intervention, Spirituality, Nursing care, Quality of life

摘要： 背景　恶性肿瘤蕈状创口，其大量的渗出、恶臭、疼痛等给患者造成生理上的痛苦和心理上的冲击。目的　探讨症状干预联合灵性照护对恶性肿瘤蕈状创口的效果。方法　选取2015年12月—2017年12月在河北医科大学第四医院门诊换药室换药的59例恶性肿瘤蕈状创口患者，治愈性治疗和姑息性治疗共同进行，对恶性肿瘤蕈状创口进行症状干预联合灵性照护，干预前、干预后2、4周分别评价患者疼痛程度、渗出程度、气味等级及采用世界卫生组织生存质量测定量表（WHOQOL-BREF）评估生活质量。结果　干预前后数字分级法（NRS）评分、渗出程度、气味等级、生理领域（PHYS）、心理领域（PSYCH）、独立性领域（IND）、社会关系领域（SOCIL）、环境领域（ENVIR）、精神支柱/宗教/个人信仰（DOM6）评分比较，差异有统计学意义（P<0.05）；其中干预后2周渗出程度、气味等级较干预前降低，PHYS、PSYCH、IND、ENVIR、DOM6评分较干预前升高，干预后4周NRS评分、渗出程度、气味等级较干预前、干预后2周降低，PHYS、PSYCH、IND、SOCIL、ENVIR、DOM6评分较干预前、干预后2周升高（P<0.05）。结论　症状干预联合灵性照护对恶性肿瘤蕈状创口处理效果良好，可以改善患者躯体症状，提高其舒适度和生活质量，并使患者心灵得到慰藉，人性得到升华，值得临床推广。

关键词: 肿瘤, 蕈状创口, 症状干预, 灵性, 护理, 生活质量