摘要
目的探讨中晚期喉癌、喉咽癌患者诱导化疗后骨髓抑制的病情观察与护理措施。方法回顾性分析2015 年3 月—2017 年6 月首都医科大学附属北京安贞医院收治的8 例中晚期喉癌、喉咽癌患者采用紫杉醇+顺铂+氟尿嘧啶(TPF)方案诱导化疗后出现骨髓抑制的临床资料,总结其治疗护理经验。护理要点包括基础护理,心理护理,病情观察与监测,用药护理,感染的预防,感染的处理,贫血及出血的预防及处理,饮食护理,活动护理。结果 15 例中晚期喉癌、喉咽癌诱导化疗后出现8 例骨髓抑制,发生率为53.33%。其中Ⅲ~Ⅳ度骨髓抑制患者3例;其中2例粒细胞下降的患者给予肌注粒细胞集落刺激因子(CSF)3~5 d后恢复正常,1 例患者血小板减少给予输注血小板+重组人血小板生成素注射液治疗3 d 后好转。所有患者均安全度过骨髓抑制期,顺利出院。结论对于中晚期喉癌、喉咽癌化疗后骨髓抑制的患者,加强基础护理和心理护理,密切观察病情变化,患者能平稳度过骨髓抑制期。
Objective To study the clinical observation and nursing strategies for myelosuppression caused by induction chemotherapy for stage Ⅲ and stage Ⅳ laryngeal and hypopharyngeal cancers. Methods The clinical data of 8 patients admitted during March 2015 to June 2017 who developed myelosuppression after induction chemotherapy using taxol + cisplatin + fluorouracil( TPF) were retrospectively analyzed for nursing strategies. Key nursing strategies included in the analysis were basic care, psychological care, condition observation and monitoring, medication care, infection prevention, infection management, prevention and treatment of anemia and bleeding, diet care and activity care. Results After induction chemotherapy, 8 out of 15( 53.33%) stage Ⅲ and stage Ⅳ laryngeal and hypopharyngeal cancer patients developed myelosuppression, among which 3 patients showed Ⅲ-Ⅳ degree myelosuppression. Granulocyte colony stimulating factor( CSF) was administered by intramuscular injection to manage reduced granulocyte level in 2 cases. The granulocyte level in both patients went back to normal after 3-5 days. Platelet and recombinant human thrombopoietin were administered by intravenous injection to manage reduced platelet in 1 case. The platelet level of the patient started to increase after 3 days. All patients successfully recovered from myelosuppression before being discharged. Conclusions For stage Ⅲ and stage Ⅳ laryngeal and hypopharyngeal cancer patients who developed myelosuppression after chemotherapy, enhanced basic care, psychological care and close observation of condition developments are essential to the patients' smooth recovery from myelosuppression.
作者
于晓霞
房居高
李晶明
孟令照
王建宏
饶远生
杨帆
Yu Xiaoxia;Fang Jugao;Li Jingming;Meng Lingzhao;Wang Jianhong;Rao Yuansheng;Yang Fan(Department of Otolaryngology-Head and Neck Surgery,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China;Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China)
出处
《中华现代护理杂志》
2019年第5期630-632,共3页
Chinese Journal of Modern Nursing
关键词
护理
喉肿瘤
耳鼻咽喉肿瘤
诱导化疗
骨髓抑制
Nursing care
Laryngeal neoplasms
Otorhinolaryngologic neoplasms
Induction chemotherapy
Myelosuppression
