患儿亲属陪护准入移植病房的临床实践

目的 探讨儿科移植病房患儿亲属陪护对临床护理及治疗的积极意义.方法 将2007年1月至2010年4月收集的37例自体外周造血干细胞移植术的患儿随机分成无陪护组7例和有陪护组30例,对有陪护组亲属进行规范的进仓前培训.对移植过程中2组患儿护理心理依从性、急性不良反应和骨髓造血功能重建时间进行分析.结果 无陪护组患儿基础护理依从性仅为28.6％,而有陪护组依从性可达到73.3％.按Bearman标准分析,无陪护组出现急性不良反应Ⅳ级1例,Ⅲ级1例,Ⅱ级4例,Ⅰ级1例；有陪护组Ⅳ级1例,Ⅲ级1例,Ⅱ级6例,Ⅰ级22例.36例患儿获得骨髓重建,无陪护组骨髓造血功能重建时间最长为41 d,平均时间为(28.14±7.98)d.有陪护组骨髓造血功能重建时间最长为22 d,平均时间为(14.61±2.33)d.结论 家属参与移植期间的陪护是安全的、可行的.亲属陪护对于患儿在移植期间的心理干预、护理依从性及成功完成移植的治疗有积极的临床意义.

Clinical practice of accompany relatives of children with access to pediatric transplantation ward

Objective To study on the significance of accompany relatives of children with access to pediatric transplantation ward on clinical treatment and nursing.Methods 37 children undergoing autologous peripheral blood stem cell transplantation (APBST) were collected from January 2007 to April 2010.All cases were divided into the no tending group(7 cases)and the tending group (30 cases).The accompany relatives of the tending group accepted standard training before entering the ward.The compliance with basic nursing,acute side-effect and hemopoiesis rebuild period of marrow during APBST in two groups were compared.Results The compliance with basic nursing of the no tending group was only 28.6％,but was 73.3％ in the tending group.According to Bearman standard,the acute side-effect of the no tending group:1 case of grade Ⅳ,1 case of grade Ⅲ,4 cases of grade Ⅱ,1case of grade Ⅰ; in the tending group:1 case of grade Ⅳ,1 case of grade Ⅲ,6 cases of grade Ⅱ,22 case of grade Ⅰ.The marrow-reconstitution took place in 36 children.The most long time was 41 days in the no tending group,the average time was (28.14+7.98)days.The time took for marrow-reconstitution was 22 days in the tending group,the average time was ( 14.61+2.33)days.Conclusions It is safe and feasible for accompany relatives of children to participate in nursing during transplantation.Relatives accompany is beneficial for psychology adaptability,nursing compliance and success of APBST.