护理干预在儿童白血病鞘内注射治疗中的应用

目的 探讨护理干预在儿童白血病鞘内注射中的应用效果。方法 收集2008年8月至2010年11月收治的30例儿童急性白血病147次鞘内注射的临床资料。随机分为干预组（75例次）和对照组（72例次）。对照组按鞘内注射常规护理，干预组在操作前、中、后予护理干预。结果干预组患儿依从率为81．3％，对照组患儿依从率为43．1％，两组比较差异有统计学意义（X2=22．97，P〈0．01），两组穿刺成功率比较差异也有统计学意义（90．7％比68．1％，X2=11．56，P〈0．01）；两组患儿对穿刺时疼痛反应情况及腰背痛、下肢疼痛麻木发生情况比较差异有统计学意义（P〈0．01）；术后胃肠反应如恶心、呕吐比较差异无统计学意义（P〉0．05）。结论护理干预能减轻患儿对穿刺时疼痛的反应，减少鞘内注射副作用，提高白血病患儿对鞘内注射的依从性，提高穿刺成功率。

Application of nursing intervention in children with leukemia during chemotherapy via lumbar puncture

Objective To study the effect of nursing intervention in children with leukemia who received chemotherapy via lumbar puncture (CMLP).Methods The data of 30 children with leukemia who received 147 times of lumbar puncture totally were collected during Aug 2008 to Nov 2010 in the First Affiliated Hospital of Anhui Medical University. These cases were randomly divided into the intervention (75 cases) and the control group (72 cases). The control group received routine nursing, the intervention group received nursing intervention before, during and after the operation.Results Significant differences were found between the two groups in the patient's compliance (81.3% vs 43.1%,χ2=22.97, P＜0.01) and the success rate (90.7% vs 68.1%,χ2=11.56, P＜0.01) of the lumbar puncture; the pain reaction, backpain and lower limb pain or numbness were significantly different(P＜0.01); the side effects in the gastrointestinal tract, e.g. nausea, vomiting showed no differences between the two groups(P>0.05).Conclusions Nursing intervention can relieve children's pain reaction to lumbar puncture, reduce side effects, improve compliance and success rate of lumbar puncture.