程序化预见性护理干预在急性白血病化疗后口腔感染中的临床价值

目的 探讨程序化预见性护理干预在急性白血病化疗后口腔感染中的临床价值.方法 选择我院收治的110例急性白血病患者为研究对象.随机分为对照组和观察组各55例.对照组化疗期间实施常规护理.观察组在对照组的基础上,采取程序化预见性护理干预,包括化疗前全面评估口腔黏膜状况,结合口腔pH值制定个性化漱口方案;化疗期间个体化健康指导;保持病室整洁,加强环境保护;均衡营养支持和全程心理支持.化疗后第3、5、10、15天采集患者口腔、硬颚、舌面舌下唾液分泌物进行涂片检查,并监测pH值.同时于化疗后第3周统计两组患者口腔感染的发生率及感染程度.应用自制的《患者满意度调查表》评价护理满意度.结果 观察组在化疗后第3、5、10、15天口腔、硬颚、舌面舌下唾液分泌物pH值均高于对照组(P＜0.05),观察组患者口腔内环境酸碱度更接近弱碱性,更有利于破坏真菌感染环境,预防口腔感染方面更具优势.化疗后第3周,观察组感染发生率明显低于对照组(P＜0.05).观察组护理总满意率明显高于对照组(P＜0.05).结论 在满足患者基本生理需要的基础上,科学实施程序化全方位预见性口腔护理,能有效降低急性白血病化疗后口腔感染的程度及全身感染率,改进患者生活质量,提高化疗依从性及护理满意度,促进病情的转归,临床价值较高,值得进一步推广.

The clinical value of programmed predictive nursing intervention for oral infection in patients with acute leukemia after chemotherapy

Objective To explore the clinical value of programmed predictive nursing intervention for oral infection in patients with acute leukemia after chemotherapy.Methods 110 cases of acute leukemia in our hospital were selected as study subjects,and randomly divided into control group and observation group with 55 cases in each groups.Control group received routine nursing during chemotherapy,and observation group received programmed predictive nursing intervention on the basis of control group,including comprehensive assessment on the status of oral mucosa before chemotherapy,the development of personalized gargle program according to oral pH value,individual health guidance during chemotherapy,keeping the ward clean,strengthening the protection of the environment,balanced nutrition support,and full psychological support.Collected oral,hard palate,tongue sublingual salivary secretions for smear test 3,5,10,15 days after chemotherapy,and monitored pH value.The incidence and the degree of oral infection in two groups were statistically analyzed in the third week after chemotherapy.Evaluated nursing satisfaction with self made Patients Satisfaction Survey Scale.Results pH value of oral,hard palate,tongue sublingual salivary secretions in observation group 3,5,10,15 days after chemotherapy were significantly higher than those in control group (P＜0.05),which showed that pH value of oral environment of patients in observation group was closer to alkalescence,more conducive to the damage of fungal infection,had more advantages in preventing oral infection.The incidence of infection in observation group was significantly lower than that in control group in the third week after chemotherapy (P＜0.05).The total nursing satisfaction rate of observation group was significantly higher than that of control group (P＜0.05).Conclusions On the basis of meeting patients' basic physiological needs,the implementation of the scientific process of full range programmed predictive oral nursing care,can effectively reduce the degree of oral infection after chemotherapy in patients with acute leukemia and the rate of systemic infection,improve the quality of life of patients,the compliance rate for chemotherapy,and nursing satisfaction degree,promote disease outcome,with high clinical value,worthy of further promotion.