中国实用护理杂志
中國實用護理雜誌
중국실용호리잡지
CHINESE JOURNAL OF PRACTICAL NURSING
2013年
31期
36-39
,共4页
蔡瑞卿%彭彩芬%覃少敏%刘美玲
蔡瑞卿%彭綵芬%覃少敏%劉美玲
채서경%팽채분%담소민%류미령
儿童恶性肿瘤患者%HLA-半相合供者免疫细胞%不良反应%护理
兒童噁性腫瘤患者%HLA-半相閤供者免疫細胞%不良反應%護理
인동악성종류환자%HLA-반상합공자면역세포%불량반응%호리
Childhood malignant patients%HLA-haploidentical donor cells%Side effects%Nursing
目的 探讨儿童恶性肿瘤患者接受体外扩增人类白细胞抗原(HLA)-半相合供者免疫细胞输注(HDICIs)的不良反应,为如何护理此类患儿提供依据.方法 2011年9月至2012年9月收治的12例儿童恶性肿瘤患者共接受92例次HDICIs,观察并记录每位患儿在HDICIs过程中、结束2h及24h内的不良反应,并为患儿提供心理护理,输注前护理,输注过程不良反应分析及护理,输注后出院宣教及随访.结果 在92次HDICIs过程中,共出现20例次发热反应,其中有6例次伴畏寒、寒战,1例次伴高热惊厥,对症处理后缓解;共出现5例次轻微情绪改变;其余各例次HDICIs过程中及结束后生命体征均平稳,无恶心、呕吐、腹痛、腹泻、皮疹、水肿、过敏反应等异常反应的发生.每程HDICIs前后,所有患儿的血象及生化指标均未见明显异常.结论 儿童恶性肿瘤患者接受HDICIs行免疫治疗是安全的;在整个治疗过程中重视心理护理,输注前的抗过敏治疗,重视体温监测、及时发现高热惊厥的前兆,重视不良反应的对症处理,重视随访和出院宣教对于儿童恶性肿瘤患者接受HDICIs行免疫治疗的顺利进行具有重要意义.
目的 探討兒童噁性腫瘤患者接受體外擴增人類白細胞抗原(HLA)-半相閤供者免疫細胞輸註(HDICIs)的不良反應,為如何護理此類患兒提供依據.方法 2011年9月至2012年9月收治的12例兒童噁性腫瘤患者共接受92例次HDICIs,觀察併記錄每位患兒在HDICIs過程中、結束2h及24h內的不良反應,併為患兒提供心理護理,輸註前護理,輸註過程不良反應分析及護理,輸註後齣院宣教及隨訪.結果 在92次HDICIs過程中,共齣現20例次髮熱反應,其中有6例次伴畏寒、寒戰,1例次伴高熱驚厥,對癥處理後緩解;共齣現5例次輕微情緒改變;其餘各例次HDICIs過程中及結束後生命體徵均平穩,無噁心、嘔吐、腹痛、腹瀉、皮疹、水腫、過敏反應等異常反應的髮生.每程HDICIs前後,所有患兒的血象及生化指標均未見明顯異常.結論 兒童噁性腫瘤患者接受HDICIs行免疫治療是安全的;在整箇治療過程中重視心理護理,輸註前的抗過敏治療,重視體溫鑑測、及時髮現高熱驚厥的前兆,重視不良反應的對癥處理,重視隨訪和齣院宣教對于兒童噁性腫瘤患者接受HDICIs行免疫治療的順利進行具有重要意義.
목적 탐토인동악성종류환자접수체외확증인류백세포항원(HLA)-반상합공자면역세포수주(HDICIs)적불량반응,위여하호리차류환인제공의거.방법 2011년9월지2012년9월수치적12례인동악성종류환자공접수92례차HDICIs,관찰병기록매위환인재HDICIs과정중、결속2h급24h내적불량반응,병위환인제공심리호리,수주전호리,수주과정불량반응분석급호리,수주후출원선교급수방.결과 재92차HDICIs과정중,공출현20례차발열반응,기중유6례차반외한、한전,1례차반고열량궐,대증처리후완해;공출현5례차경미정서개변;기여각례차HDICIs과정중급결속후생명체정균평은,무악심、구토、복통、복사、피진、수종、과민반응등이상반응적발생.매정HDICIs전후,소유환인적혈상급생화지표균미견명현이상.결론 인동악성종류환자접수HDICIs행면역치료시안전적;재정개치료과정중중시심리호리,수주전적항과민치료,중시체온감측、급시발현고열량궐적전조,중시불량반응적대증처리,중시수방화출원선교대우인동악성종류환자접수HDICIs행면역치료적순리진행구유중요의의.
Objective To analyze the side effects of in-vitro amplification human leukocyte antigen (HLA)-haploidentical donor immune cell infusion(HDICI) in childhood malignant patients,and to provide the basis for how to nurse these patients.Methods From September 2011 to September 2012,twelve hospitalized childhood malignant patients were recruited in Cancer Center of Sun Yat-sen University,and they received a total of 92 times of HDICIs for immunotherapy.Side effects were carefully observed both during and 2 hours and 24 hours after each infusion,and we also provided psychological nursing,pre-infusion nursing,side effect analysis and corresponding care during infusion,post-infusion education and follow-up for every childhood patient.Results Among 92 times of HDICIs,fever occurred in 20 cases,of whom 6 cases were with chills,1 case with febrile convulsion,all achieved remission after receiving symptomatic treatment.5 cases were also recorded with a slight change of mood.Vital signs were all stable both during and after every HDICIs; and no nausea,vomiting,abdominal pain,diarrhea,rash,swelling or allergic reaction was observed.Neither change of the hemogram nor biochemical indexes was recorded before or after every course of HDICI.Conclusions Our study showed that HDICIs for immunotherapy in childhood malignant patients were safe,and during the whole infusions,much attention should be paid both for psychological nursing,pre-infusion anti-anaphylactic treatment,temperature monitoring,discovery of the precursor of febrile convulsion promptly,symptomatic treatment against corresponding side effects,and post-infusion education and follow-up,all those above are of great importance for childhood malignant patients who received HDICIs for immunotherapy successfully.
