酪氨酸激酶抑制剂治疗晚期恶性肿瘤并发高血压的情况及其护理措施

目的 观察酪氨酸激酶抑制剂(tyrosine kinase inhibitors，TKI)治疗晚期恶性肿瘤患者并发高血压的情况，并探讨其相应的治疗和护理措施。方法 选择2011年2月—2014年1月采用帕唑帕尼、索拉非尼、阿昔替尼和舒尼替尼治疗晚期恶性肿瘤患者97例，按照2010年中国高血压防治指南对产生高血压的患者进行分级，然后采取相应的降压治疗与护理措施。结果 29例(29.9%)接受TKI治疗的恶性肿瘤患者产生高血压的不良反应，其中单纯收缩期高血压6例(6.2%)，1级高血压11例(11.3%)，2级高血压12例(12.4%)，无3级高血压患者。治疗期间首次发生高血压的最早中位时间为4.0 d，护理后患者平均血压明显降低。结论 通过及时的降压药物治疗，切实做好病因检查、病情监测、用药护理、健康教育、心理护理和饮食护理等护理干预措施，对保证TKI治疗恶性肿瘤安全、顺利进行，提高患者治疗效果和生存质量有重要的临床意义。

Observation and Nursing for Hypertension of Patients with Advanced Malignant Tumor Caused by Tyrosine Kinase Inhibitors

OBJECTIVE To observe the hypertension of patients with malignant tumor treated by Tyrosine kinase inhibitors(TKI), and to discuss the treatment and nursing measures of the hypertension. METHODS Ninty-seven patients with malignant tumor who were treated with Pazopanib, sorafenib, sunitinib and axitinib from Feb 2011 to Jan 2014 were selected, the hypertension of patients were analyzed according to 2010 Chinese guidelines for the management of hypertension. Then the treatment and nursing measures of the hypertension were given. RESULTS Twenty-nine patients (29.9%) who accepted TKI had hypertension, 6 patients (6.2%) had simple systolic hypertension, 11 patients (11.3%) had hypertension of Grade 1, 12 patients (12.4%) had hypertension of Grade 2, none of the patients had shypertension of Grade 3. The earlist medium time from the initiation of treatment to the occurrence of hypertension was 4.0 days. The blood pressure lowered significantly after the nursing. CONCLUSION Timely antihypertensive drug treatment, etiology inspection, condition monitoring, medication nursing, health education, psychological nursing, diet nursing and nursing intervention measures have an important clinical significance to ensure TKI to treat malignant tumor safely and favorably, all the items above can improve the effect of treatment and quality of life of patients.