造血干细胞移植：受者的心理特点及心理支持

背景：造血干细胞移植是治疗各类白血病、淋巴瘤等血液系统疾病的主要手段，移植过程存在着许多影响治疗效果的负性因素，对于患者能够顺利完成造血干细胞移植有着重要的影响。 目的：分析造血干细胞移植患者心理特点，重点评价心理干预实施效果。 方法：2012年1月至2013年12月造血干细胞移植中心共收治患者92例，多数患者均实施过自体外周血干细胞移植，接受异体干细胞移植55例，其中同胞48例，非血缘外周血造血干细胞移植7例，部分行骨髓抑制或复合移植。针对移植过程中不同阶段负性因素的特点，实施心理支持、并发症预防观察与处理、全环境保护方案等干预措施。 结果与结论：所有患者造血干细胞移植均获得成功，遵医行为良好，未出现心理应激、情绪失控、破坏物品等不良事件，服药依从性、饮食依从性、作息依从性均良好。2012年与2013年并发症发生率、不良事件发生率、患者满意率差异无显著性意义(P > 0.05)。由于造血干细胞移植具有较强的特殊性，患者需要严格的治疗路径，留置层流病房较长，行为严重受限，承受较大的心理、生理负担，应严格落实无菌标准，加强病区管理，做好患者指导、支持工作，减少移植并发症发生，使移植能够顺利完成。中国组织工程研究杂志出版内容重点：干细胞；骨髓干细胞；造血干细胞；脂肪干细胞；肿瘤干细胞；胚胎干细胞；脐带脐血干细胞；干细胞诱导；干细胞分化；组织工程全文链接：

Hematopoietic stem cell transplantation: psychological characteristics and psychological support in recipients

BACKGROUND: Hematopoietic stem cell transplantation is the main treatment for leukemia, lymphoma and other blood diseases, but there are various negative factors during the transplantation process that have important implications for the success of hematopoietic stem cell transplantation. OBJECTIVE: To analyze the psychological characteristics of patients undergoing hematopoietic stem cell transplantation and to focus on the implementation effects of psychological intervention. METHODS: From January 2012 to December 2013, totally 92 patients were admitted at the Hematopoietic Stem Cell Transplantation Center, the majority of whom had received autologous peripheral blood stem cell transplantation. Fifty-five of 92 patients were subjected to allogeneic stem cell transplantation, including 48 cases of relative sources and 7 of unrelated peripheral blood stem cell transplantation. Bone marrow suppression and composite grafting were carried out in some patients. According to the characteristics of negative factors at the different stages of stem cell transplantation, targeted interventional measures were performed, including psychological supports, prevention, observation and treatment of complications, and whole environmental protection programs. RESULTS AND CONCLUSION: Hematopoietic stem cell transplantation was successfully implemented in all patients who had good compliance behaviors (medication, diet, and daily schedule), and had no the following adverse events: psychological stress, out of emotional control, destroying objects. No significant difference was found in the incidence of complications, the incidence of adverse events, and patient satisfaction rate during 2012-2013 (P > 0.05). Because the hematopoietic stem cell transplantation has strong specificity, patients need to strictly comply with the treatment path, stay long in laminar flow wards longer, and bear a greater psychological and physiological burden, whose behaviors are severely restricted. We should strictly implement aseptic standards, strengthen ward management and provide good guidance and support for patients, so as to reduce post-transplantation complications and ensure the successful completion of hematopoietic stem cell transplantation.