1例免疫检查点抑制剂相关暴发性心肌炎患者的护理  

Nursing care of a patient with immune checkpoint inhibitor-associated fulminant myocarditis

作　　者：邱小英 石泽亚[2] 张艳 李利花[1] 吴娟 QIU Xiaoying;SHI Zeya;ZHANG Yan;LI Lihua;WU Juan

机构地区：[1]湖南省人民医院(湖南师范大学附属第一医院)心血管内科,长沙市410005 [2]湖南省人民医院(湖南师范大学附属第一医院)护理教研室,长沙市410005

出　　处：《中华护理杂志》2022年第14期1744-1748,共5页Chinese Journal of Nursing

基　　金：湖南省卫生健康委一般资助课题(202114012086);湖南省社科基金资助项目(18YBA315)。

摘　　要：心肌炎是免疫检查点抑制剂相关的高致死率免疫不良反应,其诊断、治疗及护理均较为复杂。该文总结1例低分化肺腺癌患者应用免疫检查点抑制剂并发暴发性心肌炎患者的护理,护理要点包括病情监测与预评估、体外膜肺氧合支持的护理、降低感染加重风险、并发症的预防与护理、康复指导和健康教育。经过25 d的积极治疗和精心护理,患者病情好转并顺利出院,电话随访6个月,状况良好。Myocarditis is a highly lethal immune adverse reaction associated with immune checkpoint inhibitors(ICIs),and its diagnosis,treatment and nursing are complicated. This paper summarizes the nursing care of a patient with low-differentiated lung adenocarcinoma complicated with fulminant myocarditis who was treated with ICIs.The key points of nursing care include:monitoring and pre-evaluation of the condition,nursing care supported by ECMO,reducing the risk of infection aggravation,prevention and nursing care of complications,rehabilitation guidance and disease education. After 25 days of active treatment and careful nursing care,the patient’s condition improved and he was discharged smoothly. Telephone follow-up for 6 months showed good condition.

关 键 词：免疫检查点抑制剂 暴发性心肌炎 体外膜肺氧合 护理 

分 类 号：R473.73[医药卫生—护理学]