神经母细胞瘤患儿接受嵌合抗原受体修饰T细胞回输后不良反应的护理  

Nursing experience of children with neuroblastoma developing adverse reaction after re-transfusion of chimeric antigen receptor-transduced T-cells

作　　者：丁亚光[1] 赵文[1] 吴心怡[1] 马晓莉[1] 

机构地区：[1]首都医科大学附属北京儿童医院血液肿瘤中心,北京市100045

出　　处：《中华护理杂志》2017年第3期307-310,共4页Chinese Journal of Nursing

基　　金：北京市科委-首都特色专项基金资助(Z1511000040-15159)

摘　　要：总结11例难治或复发的神经母细胞瘤患儿接受嵌合型抗原受体修饰的T细胞回输治疗后不良反应的护理经验。护理要点包括:严密监测患儿生命体征,重点监测体温和血压的变化;观察患儿皮肤,出现皮疹后,避免挠抓,涂抹炉甘石洗剂;严格记录患儿24 h出入量,保证静脉通路的通畅并匀速输入含有张力的液体,观察尿量及尿色的变化;加强感染的预防,严格执行无菌操作,入住层流单间病房并给予保护性隔离。精心的护理保证了患儿治疗的顺利进行。This paper summarized nursing experience of 11 patients with refractory or relapsed neuroblastoma who developed CAR-T adverse reaction after receiving the transfusion. Nursing key points included：close monitoring of changes of vital signs,especially body temperature and blood pressure; observation of changes of skin,avoiding scratching when skin rash occurred,and daub calamine lotion was applied; strict recording input and output volume of 24 hours,ensuring patency of venous catheters and constant infusion of liquid,observing changes of urine volume and color; strengthening prevention of infection,strict operation of antiseptic technique,protective isolation when moving in laminar flow clean room; monitoring changes of face ,breathing ,blood oxygen and so on. Through careful treatment and nursing care ,the treatment of children was ensured.

关 键 词：儿童 神经母细胞瘤 嵌合抗原受体修饰的T细胞 护理 

分 类 号：R473.73[医药卫生—护理学]