两性霉素B治疗血液病合并真菌性败血症的护理体会

目的 探讨血液病合并真菌性败血症时应用两性霉素B过程中的并发症及其护理,以提高其在应用过程中的安全性。方法 对异基因造血干细胞移植3例(SAA 2例、ALL1例)和白血病化疗后7例(CLL2例、M55例),出现真菌性败血症时应用长程(1～3个月)的两性霉素B治疗,总剂量为1750～3115 mg,观察其疗效和并发症,且对并发症采用药物预防和护理。结果 9例患者治愈,1例自动出院,绝大部分患者在治疗的早期有畏寒和寒颤,半数患者出现低钠和低钾血症、恶心、呕吐消化道症状,少数患者出现肝肾功能的轻度损害和一过性的心律失常、低血压和静脉炎 经(?)应的药物和护理处理后均能控制。结论 预防和早期发现并发症并予有效的治疗和护理是两性霉素(?)用药的关键。

NURSING CARE OF AMPHOTERICIN B FOR FUNGOUS SEPTICAEMIA COMPLICATION OF HAEMATOLOGIC DISEASES

Objective To explore the treatment and care of Amphoteriein B for fungous septicemia complication of hemotopoietic stem cell transplantation or chemotherapy (?)department of hematology and to improve the safety of using it. Methods We used Amphotericin B for for fungous septicemia complicated with allo- geneic hematopoiefie stem cell transplantation (2 cases of server aptastic anemia, 1 case of acute lymphoblastic leukemia) or chemotherapy (2 cases of chronic lymphoblastic leukemia, 5 cases of acute monoblastic leukemia). The long-term of one to three months Amphotericin B was used at total dose range from 1750 to 3115 microgram with drug prophylaxis arid care. We discovered its effects and complications. Results Nine patients were cured and one leaved liospital voluntarily. Most of patients presented chills at the early stage of treatment, half presented hypokalemia and hyponatremia followed by vomiting and nausea. Minority of patients presented mild liver and renal function damage and transitory cardiac arrhythmia, hypotension and phlebifis. All complications were controlled by the way of drug prophylaxis and clinical care. Conclusion The keys of safely using of Amphotericin B are prophylaxis,early discovery and effective treatment and care.