大剂量氨甲喋呤治疗急性淋巴细胞性白血病的观察和护理

目的探讨大剂量氨甲蝶呤连续24h静脉滴注、甲酰四氢叶酸钙解救方案治疗急性淋巴细胞性白血病(ALL)的护理方法。方法对32例ALL患者行大剂量氨甲蝶呤-甲酰四氢叶酸钙解救疗法(HD-MTX-CF-R)化疗期间实施相应的护理措施,包括加强心理护理、化疗用药护理、口腔粘膜炎护理、骨髓抑制护理及饮食护理等,观察其护理效果,并进行总结。结果毒性分级按WHO常规毒性分级标准进行评价,全身状况按ECOG评估标准进行评估,全部病例无严重毒副作用发生,部分患者出现恶心、呕吐、肝功能损害、口腔粘膜毒性等。结论HD-MTX-CF-R方案治疗ALL患者,通过严格执行化疗计划,严密的病情观察,强化化疗护理,可以有效地预防和减轻毒性反应,保证化疗完成,取得满意的治疗效果。

Observation and Nursing Care of Acute Lymphoblastic Leukemia in Treated with High Dosage Methotrexate

Objective To study the nursing methods of high dosage methotrexate followed by rescue with calcium formyltetrahydrofolate in the treatment of acute lymphoblastic leukemia.Methods During the therapy of HD-MTX-CF-R,the appropriate measures of nursing care were carry out to 32 patients of ALL,which include mental nursing,the nursing of chemotherapy,mouth care,the nursing of food and drink,and so on. Then the effect of the treatment was observed,and the summary was made.Results During the therapy of HD-MTX-CF-R,there were no serious toxic reaction that was found in all the patients. But some of the case had low-grade nausea,vomiting,liver functional lesion,mucositis.Conclusion The method of HD-MTX-CF-R is a feasible and safe practice for the treatment of ALL patient. Strict implementing the project of chemotherapy,rigorous observing pathogenetic condition and strengthening the nursing care can efficiently prevent the patient from the suffering or ease the patient's suffering ,ensure the smooth treatment,and gain the satisfactory effect of treatment.