中国实用护理杂志
中國實用護理雜誌
중국실용호리잡지
CHINESE JOURNAL OF PRACTICAL NURSING
2010年
26期
15-18
,共4页
吴云%谯川南%程洁慧%洪梅
吳雲%譙川南%程潔慧%洪梅
오운%초천남%정길혜%홍매
脐血干细胞移植%深低温冻存%骨髓腔内注射%护理
臍血榦細胞移植%深低溫凍存%骨髓腔內註射%護理
제혈간세포이식%심저온동존%골수강내주사%호리
Cord blood stem cell transplantation%Cryopreservation%Intra-bone marrow injection%Nursing
目的 探讨如何做好深低温冻存脐血的安全有效输注和护理.方法 对78例患者111份脐血经不同输注途径回输过程中出现的不良反应进行观察及护理.结果 静脉回输途径:67例中1例发生急性溶血反应;1例突发意识丧失,全身抽搐;4例发生剧烈头痛,伴呼吸困难、血压急剧升高;46例发生部分及不同程度的手脚、颜面部麻木,恶心呕吐,腹痛伴便意,呼吸困难伴胸部压迫感,血压升高,心率减慢或血压降低、心率加快,其中1例出现无症状性频发早搏;大部分病例出现回输后肉眼血红蛋白尿.骨髓腔注射回输途径:11例患者在注射过程仅发生局部及双下肢放射性酸胀,血红蛋白尿症状轻或无血红蛋白尿症状.78例患者111份脐血均成功输完,患者生命安全.结论 静脉回输脐血不良反应以严重的全身反应为主,病情变化快且复杂,护理重点为充分预防准备,严密病情观察和积极有效对症处理;骨髓腔注射脐血不良反应以局部胀痛为主,护理重点为严格遵守无菌操作,掌握脐血注射时间.
目的 探討如何做好深低溫凍存臍血的安全有效輸註和護理.方法 對78例患者111份臍血經不同輸註途徑迴輸過程中齣現的不良反應進行觀察及護理.結果 靜脈迴輸途徑:67例中1例髮生急性溶血反應;1例突髮意識喪失,全身抽搐;4例髮生劇烈頭痛,伴呼吸睏難、血壓急劇升高;46例髮生部分及不同程度的手腳、顏麵部痳木,噁心嘔吐,腹痛伴便意,呼吸睏難伴胸部壓迫感,血壓升高,心率減慢或血壓降低、心率加快,其中1例齣現無癥狀性頻髮早搏;大部分病例齣現迴輸後肉眼血紅蛋白尿.骨髓腔註射迴輸途徑:11例患者在註射過程僅髮生跼部及雙下肢放射性痠脹,血紅蛋白尿癥狀輕或無血紅蛋白尿癥狀.78例患者111份臍血均成功輸完,患者生命安全.結論 靜脈迴輸臍血不良反應以嚴重的全身反應為主,病情變化快且複雜,護理重點為充分預防準備,嚴密病情觀察和積極有效對癥處理;骨髓腔註射臍血不良反應以跼部脹痛為主,護理重點為嚴格遵守無菌操作,掌握臍血註射時間.
목적 탐토여하주호심저온동존제혈적안전유효수주화호리.방법 대78례환자111빈제혈경불동수주도경회수과정중출현적불량반응진행관찰급호리.결과 정맥회수도경:67례중1례발생급성용혈반응;1례돌발의식상실,전신추휵;4례발생극렬두통,반호흡곤난、혈압급극승고;46례발생부분급불동정도적수각、안면부마목,악심구토,복통반편의,호흡곤난반흉부압박감,혈압승고,심솔감만혹혈압강저、심솔가쾌,기중1례출현무증상성빈발조박;대부분병례출현회수후육안혈홍단백뇨.골수강주사회수도경:11례환자재주사과정부발생국부급쌍하지방사성산창,혈홍단백뇨증상경혹무혈홍단백뇨증상.78례환자111빈제혈균성공수완,환자생명안전.결론 정맥회수제혈불량반응이엄중적전신반응위주,병정변화쾌차복잡,호리중점위충분예방준비,엄밀병정관찰화적겁유효대증처리;골수강주사제혈불량반응이국부창통위주,호리중점위엄격준수무균조작,장악제혈주사시간.
Objective To investigate the safety of infusion and effective care of cryopreserved umbilical cord blood. Methods Side effects happened during transfusion of cord blood in 78 patients of 111times of transfusion were observed and nursed. Results During intravenous transfusion way:1 case with acute hemolytic reaction; 1 case with sudden loss of consciousness and convulsions; 4 cases with severe headache, difficulty with breathing, rapid increase of blood; 46 patients with high blood pressure, heart rate or blood pressure, heart rate, 1 patient had symptoms of frequent premature beats; most of the cases have hemoglobinuria after the infusion. Transfusion of bone marrow injection of ways: 11 patients have radioactive soreness in leg, hemoglobinuria hemoglobinuria mild symptoms or no symptoms during the process of infusion. Conclusions Systemic reactions were the main side effects during intravenous transfusion of cord blood, conditions change fast and complex, Nursing should focus on preventive care and preparation,close observation and active and effective symptomatic treatment; reaction of bone marrow injection of umbilical cord blood was local pain, the focus of nursing was aseptic operation and injection time.
