大剂量顺铂治疗晚期神经母细胞瘤患儿的护理干预评价  

Effect of nursing intervention on the children with advanced neuroblastoma treated by high dose cisplatin

作　　者：常璇[1] 梁辉[1] 赵燕[1] 

机构地区：[1]解放军总医院小儿内科,100853北京

出　　处：《中华现代护理杂志》2008年第18期1960-1961,共2页Chinese Journal of Modern Nursing

摘　　要：目的观察以大剂量顺铂为主的化疗方案治疗晚期神经母细胞瘤患儿的不良反应，探讨护理干预的效果。方法对接受大剂量顺铂方案化疗的神经母细胞瘤患儿36例，随机分为对照组和干预组各18例。对照组按儿童肿瘤化疗的护理常规进行护理；干预组实施包括心理支持、认知干预和行为干预在内的全面护理干预。观察两组肾脏损害、胃肠道反应、黏膜损害、肝功能损害及骨髓抑制等不良反应的发生率。结果干预组Ⅲ度以上严重肾功能损害1例、胃肠道反应11例、黏膜损害13例与对照组的差异经χ^2检验，具有统计学意义（P〈0．05），而Ⅲ度以上白细胞减低和肝功能损害的发生率两组之间差异无统计学意义（P〉0．05）。结论积极、科学的护理干预可以减轻神经母细胞瘤患儿应用大剂量顺铂不良反应的发生。Objective To observe the adverse effects of the children with advanced neuroblastoma treated by high dose cisplatin and investigate the effectiveness of the nursing intervention. Methods 36 children with neuroblastoma treated by high dose cisplatin who were hospitalized from March, 2002 to march, 2007 were randomly divided into the intervention group and the control group, there were 18 cases in each group. The control group received routine nursing. The intervention group received comprehensive nursing intervention including psychological support, cognitive intervention and behavior intervention. The adverse effects including kidney injury, digestive reaction, mucosa ulcer, hepatic injury and bone marrow depression between the two groups were observed and compared. Results The incidence ratio of more than grade three side effects for kidney injury, digestive reaction and mucosa ulcer in intervention group were markedly lower than that of control group （ P 〈 0. 05 ）. And the rate of the severe side effects for hepatic injury and bone marrow depression between the two groups were no markedly difference （ P 〉 0. 05 ）. Conclusions Effective and scientific nursing intervention could decrease the side effects in children received chemotherapy by high dose cisplatin.

关 键 词：神经母细胞瘤 顺铂 儿童 护理 

分 类 号：R473.73[医药卫生—护理学]