综合干预及护理对降低外周血造血干细胞采集术常见不良反应发生率的作用

目的 探讨综合干预及护理措施,对于降低外周血造血干细胞(PBSC)采集术常见不良反应发生率的作用.方法 选取2013年1月至2016年5月,于四川大学华西医院血液科接受自体PBSC采集术的160例患者为研究对象.按照这160例患者人院顺序号的奇、偶数,将其随机分为研究组和对照组,每组各80例患者.对于研究组患者,移植护士在患者接受自体PBSC采集术前、术中、术后,均对其在常规护理措施基础上,采取实时的、有针对性的综合干预及护理措施.对于对照组患者,移植护士在自体PBSC采集术前、术中、术后,均对其仅采取常规护理措施.统计学比较2组患者的一般临床资料及PBSC采集术的常见不良反应(焦虑/恐惧、失眠、食欲减退、低钙血症、血流不足、穿刺部位血肿、疲劳)发生率.本研究遵循的程序符合四川大学华西医院人体试验委员会所制定的伦理学标准,得到该委员会批准,分组征得受试者本人的知情同意,并与之签署临床研究知情同意书.结果 2组患者性别、病程及疾病类型构成比,以及年龄、人体质量指数等一般临床资料比较,差异均无统计学意义(P＞0.05).研究组患者焦虑/恐惧、失眠、食欲减退、低钙血症、血流不足和穿刺部位血肿发生率,均较对照组低,2组比较,差异均有统计学意义(x2=13.333,P＜0.001;x2 =14.444,P＜0.001;x2 =5.270,P=0.022;x2 =12.101,P＜0.001;x2 =6.632,P=0.010;x2 =7.779,P=0.005).2组患者疲劳发生率比较,差异无统计学意义(P＞0.05).结论 移植护士合理的综合干预及护理措施,可明显改善接受PBSC采集术患者的心理状态,降低其焦虑/恐惧、失眠、食欲减退、低钙血症、血流不足和穿刺部位血肿等不良反应的发生率.

Effects on reduction adverse reactions rates of peripheral blood stem cell collection by measures of comprehensive interventions and nursing cares

Objective To study the effects of comprehensive interventions and nursing measures on reducing the adverse reactions rates of collecting peripheral blood stem cell (PBSC).Methods From January 2013 to May 2016,a total of 160 patients who received autologous PBSC collection in Department of Hematology,West China Hospital,Sichuan University were chosen as study subjects.According to their odd and even numbers of admission orders,they were randomly divided into research group and control group,and 80 patients in each group.For research group,real-time and specific comprehensive interventions and nursing cares were performed in addition to regular nursing measures before,during and after autologous PBSC collecting.For control group,in contrast,only regular nursing measures were performed before,during and after autologous PBSC collecting.The general clinical informations and adverse reactions (including anxiety/fear,insomnia,anorexia,hypocalcemia,insufficient blood flow,puncture site hematoma and physical exhaustion) rates in two groups were recorded and compared by statistical methods.The procedures followed in this study were in line with the ethical standards promulgated by the Ethical Review Board of Investigation in Human Being of West China Hospital,Sichuan University.Informed consent was obtained from each participating patient.Results There were no significant differences between two groups in composition ratio of gender,course of disease,disease type,and age,body mass index,and so on (P＞0.05).The adverse reactions rates in research group among anxiety/fear,insomnia,anorexia,hypocalcemia,insufficient blood flow,and puncture site hematoma all were distinguished lower than those in control group,and all the differences were statistically significant (x2 =13.333,P＜0.001;x2=14.444,P＜0.001;x2=5.270,P=0.022;x2 =12.101,P＜0.001;x2=6.632,P=0.010;x2=7.779,P=0.005).There was no significant difference between two groups in adverse reaction rate of physical exhaustion (P ＞ 0.05).Conclusions Combination of comprehensive intervention and nursing measures can significantly improve the psychological state of autologous PBSC collection patients and reduce the adverse reactions rates of anxiety/fear,insomnia,anorexia,hypocalcemia,insufficient blood flow,and puncture site hematoma,except of physical exhaustion.