1例免疫检查点抑制剂相关重度胆汁淤积性混合型肝脏毒性肺癌患者的护理  

Nursing care for severe cholestatic mixed hepatotoxicity associated with immune checkpoint inhibitors:a case report

作　　者：刘玉[1] 陈岁花 朱苗苗 覃惠英[2] Liu Yu;Chen Suihua;Zhu Miaomiao;Qin Huiying(Department of Clinical Research,Sun Yat-sen University Cancer Centre,Guangzhou 510060,Guangdong Province,China;Department of Nursing Administration,Sun Yat-sen University Cancer Centre,Guangzhou 510060,Guangdong Province,China)

机构地区：[1]中山大学肿瘤防治中心临床研究部,广东广州510060 [2]中山大学肿瘤防治中心护理部,广东广州510060

出　　处：《现代临床护理》2024年第8期34-40,共7页Modern Clinical Nursing

基　　金：广东省医学科学技术基金项目,项目编号为A2022020。

摘　　要：总结1例免疫检查点抑制剂相关重度(G4级)胆汁淤积性混合型肝脏毒性肺癌患者的护理经验。护理要点:密切观察患者肝脏生化指标与体征;早期应用糖皮质激素联合其他免疫抑制药物;舒缓皮肤不适症状;预防机会性感染;给予个体化的运动、营养、睡眠和心理护理。29d后患者肝脏毒性降至G1级,予转换口服免疫抑制药物治疗后出院。经过2个月的定期随访,患者肝功能恢复良好。This paper summarises the nursing experiences with a lung cancer patient who suffered Grade 4 mixed hepatotoxicity characterised with cholestasis.Summarised key care measures include close observation of liver biochemical indexes,timely and safe administration of immunosuppressants,implementation of skincare procedure,prevention of opportunistic infections,individualised exercises,nutrition care,sleep care and psychological care.The patient was discharged with oral immune inhibitors after 29 days of hospitalisation when the hepatotoxicity had been improved and down to Grade 1.In the second month of follow-up,the patient had a wellrecovered liver function.

关 键 词：免疫检查点抑制剂 免疫检查点抑制剂相关肝脏毒性 胆汁淤积 个案护理 

分 类 号：R473.73[医药卫生—护理学]