妊娠滋养细胞肿瘤患者化疗骨髓抑制期病情观察及护理

目的 总结妊娠滋养细胞肿瘤患者化疗骨髓抑制期病情观察及护理要点.方法 2009年1月-2011年9月对38例滋养细胞肿瘤患者实施放线菌素-D+5-氟尿嘧啶联合化疗.观察患者骨髓抑制期白细胞及中性粒细胞变化情况,并采取针对性的护理对策.结果 化疗第7d至化疗结束7d内患者白细胞总数及中性粒细胞最低,其中26例患者出现Ⅰ度骨髓抑制,6例患者出现Ⅱ度骨髓抑制,3例患者出现Ⅲ度骨髓抑制,3例患者出现Ⅳ度骨髓抑制;骨髓抑制期19例患者出现轻度口腔炎；3例患者出现严重口腔炎伴高热,5例患者出现腹泻,1例患者出现会阴溃疡.结论 妊娠滋养细胞肿瘤患者化疗骨髓抑制期间,应密切观察患者血象变化情况,减轻患者化疗的毒副反应,预防及控制患者由于抵抗力下降引起的感染,使患者顺利渡过化疗骨髓抑制危险期.

Nursing gestational trophoblastics tumor patients with bone marrow depressing from chemotherapy

Objective To summarize the nursing points in nursing the gestational trophoblastics tumor chemotherapy patients with bone marrow depressing from chemotherapy. Methods 38 gestational trophoblastics tumor patients were managed with chemotherapy of actinomycin-D and 5-Efudex. The changes in WBC and neutrophilic granulocyte during bone marrow depressing were observed and the corresponding nursing strategies were conduced. Results The total numbers of WBC and neutrophilic granulocyte reached the lowest from day 7 from chemotherapy to day 7 after finish of the chemotherapy ： 26 patients came out with degree I bone marrow depressing, 6 with degree II , and 3 with degree III. Symptomatically, 19 of them had mild stnmatitis, 3 severe stomatitis combined with high fever, 5 contracted diarrhea and I perineal ulcers. Conclusion In nursing the gestational trophoblastics tumor patients with bone marrow depressing from chemotherapy, their hemograms should be closely observed. The infections from lower resistance should be prevented and controlled and the adverse reactions from chemotherapy should be alleviated so that they can live through the bone marrow depressing period.