雷公藤制剂致血液毒性反应的回顾性分析及临床护理启示

目的：通过对雷公藤制剂所致血液系统毒性反应病例进行回顾性分析,从临床护理角度提高认识及应对.方法：检索中国生物医学文献数据库、中国期刊全文数据库及中文科技期刊数据库,收集雷公藤制剂引起血液系统毒性反应的病例,对毒性反应的发生特点进行归纳总结.结果：共检索到文献19篇,病例25例,其毒性反应主要表现为：全身不适,腹痛,腹泻,伴发热,重度贫血、鼻出血、皮肤瘀斑等,严重者可致急性再生障碍性贫血、粒细胞缺乏症、骨髓抑制、类白血病反应等.结论：雷公藤制剂具有血液毒性,在用药过程中应严格掌握其适应证和禁忌证,临床护理工作非常重要,关注配伍减毒、控制给药时间以及观察药物毒性反应等.

Retrospective analysis and clinical nursing experience of Tripterygiumwilfordii agents to blood system toxicity adverse reactions

Objective： To retrospectively analyze the blood system toxicity caused by tripterygium wilfordii agents reported inliteratures of adverse reaction cases in order to put forward advice and countermeasures from the perspective of nursing. Methods： Toretrieve the Chinese biomedical literature database, China journal full-text database and Chinese science and technology periodical database,collect cases of toxicity of tripterygium wilfordii agents leading to blood system and summarize the characteristic of its adverse reactions.Results： 19 references, 25 cases were collected with main manifestations of the whole body discomfort, abdominal pain, diarrhea,associated with fever, severe anemia, nose bleeding, skin ecchymosis, severe cases with acute aplastic anemia and pure red aplastic anemiaand agranulocytosis, bone marrow suppression, type of leukemia, etc. Conclusion： Due to Tripterygium wilfordii agents with blood systemtoxicity, nursing is very important in the process of drug, the nursing should strictly follow the indications and contraindications, reasonablecontrol of delivery time and focus on compatibility attenuated and taboos.