HLA单倍体相合骨髓移植成功治疗2例幼儿急性白血病的护理

Nursing care of two children patients with leukemia who successfully accepted HLA haploidentical allogeneic bone marrow transplantation

目的探讨和总结HLA单倍体骨髓移植治疗幼儿白血病的护理。方法根据患儿年龄较小的特点,让其母亲进入层流间,以改善儿童的心理状态,通过针对性的进行预处理、锁骨下静脉插管、预防感染及各种并发症观察和护理。结果2例患儿移植期间心情愉快,未出现哭闹要出层流间的现象,未发生感染,在＋10d和＋14d造血干细胞功能恢复,＋37d和＋64d顺利渡过急性GVHD排异期,经检测HLA为供者型,分别于＋108d和98d出院。结论针对性护理措施是2例幼儿单倍体移植成功关键之一。

Objective To explore and summarize the nursing for the children patients accepted haploidentical bone marrow transplantation. Methods According the feature of being an infant having a small age, we let their mothers go into the flow room together with their children, so as to improve the state of children＇s psychology. In addition, specific nursing care was done during the time when the two children were prepared with a myeloablative conditioning regimen and subclavian vein catheterization. These methods were effective for preventing from infections and the occurrence of various complications. Results Two infant patients with leukemia were happy during the period of haploidentical bone marrow transplantation. Neither of them was crying for going out of the flow room. There was no evidence of infection. They established a successful engraftment at the time points, 10 days and 14 days after transplantation. And acute GVHD did not occur at day ＋37 and ＋64 day. At the time, the analysis of HLA showed a total donor-derived type. All of the patients were discharged from our hospital, at days 108 and 98 after the transplantation, respectively. Conclusions The specific nursing countermeasure is one of the key reasons for the success treatment of the two children with leukemia in haploidentical bone marrow transplantation.