40例儿童晚期神经母细胞瘤化疗的护理  

Nursing of 40 children with advanced neuroblastoma during chemotherapy

作　　者：任尉华[1] 张静[1] 张丹[1] 

机构地区：[1]解放军总医院小儿内科,北京100853

出　　处：《军医进修学院学报》2010年第2期155-156,共2页Academic Journal of Pla Postgraduate Medical School

摘　　要：目的探索晚期神经母细胞瘤患儿长期大剂量化疗的护理特点。方法选择40例神经母细胞瘤患儿，男26例，女14例，7-9岁15例，2-6岁25例；Ⅲ期19例，Ⅳ期21例。化疗方案CDV4个疗程、GiE2个疗程。留置PICC管，化疗药物以连续静脉滴注48～72h为主，并持续水化、碱化，同时进行心理、化疗副作用的护理。结果通过对患儿全面评估，仔细观察病情，对化疗副作用如胃肠道反应、骨髓抑制、出血性膀胱炎进行及时讲解及处理，对患儿及其家长有效的进行心理护理，降低了并发症及死亡率，顺利完成整个化疗，未发生静脉炎，并完成水化、碱化：结论PICC管可以减轻反复静脉穿刺的疼痛及静脉炎的发生；细致周到的护理，可增强患儿接受化疗、战胜疾病的信心，保证治疗效果.Objective To explore the nursing characteristics of children with advanced neuroblastoma during long-term and high- dose chemotherapy. Methods Forty children （26 males and 14 females） with neuroblastoma were included in this study. Of the 40 children, 15 were older than 7-9 years and 25 were 2-6 years old, 19 were at stage Ⅲ and 21 were at stage Ⅳ . Chemotherapy consisted of four courses of CDV and two courses of CiE. PICC catheter were indwelled in the children. Chemotherapeutic drugs were given by intravenous infusion for 48-72h and sustained hydration and alkalification were conducted. The side effects of psychotherapy and chemotherapy were monitored. Results The side effects of chemotherapy, such as gastrointestinal reactions, inhibition of bone marrow, and hemorrhagic cystitis, were explained to the children and managed. The children and their parents received psychological nursing. Conclusion Indwelling PICC catheter can alleviate the pain due to repeated venipuncture and reduce the incidence of phlebitis in children with advanced neuroblastoma. Careful nursing of such children can strengthen their confidence in receiving chemotherapy, overcoming the disease, and improving therapeutic effect.

关 键 词：儿童 神经母细胞瘤 化疗 护理 

分 类 号：R725[医药卫生—儿科]