马法兰预处理行自体外周血造血干细胞移植患儿的护理

Nursing for pediatric patients under auto - BMT using melphalan as conditioning regimen

目的总结14例以马法兰预处理行自体外周血造血干细胞移植患儿的护理特点。方法根据儿童的生理特点行移植前的各项准备，并放置双通道中心静脉插管。预处理方案采用卡铂和足叶乙甙24h持续静脉滴注，加马法兰，连用4d。结果经中心静脉双通道持续静滴化疗药物4d，未发生渗漏等现象，耐受性好；均发生了感染、较严重的消化道反应及严重的口腔黏膜溃烂水肿，均伴有严重的孤独感和心理负担。通过加强无菌观念，做好口腔护理、肛周护理等基础护理工作，并重视心理护理14例患儿的各种并发症均痊愈，移植成功。结论中心静脉插管有利于顺利实施连续4d的化疗，用马法兰等预处理的移植患儿伴有十分严重的并发症，认真细致的护理至关重要。

Objective To investigate nursing features of 14 pediatric patients under auto - BMT using melphalan as conditioning regimen. Methods Before BMT, according the physiological features of children, everything should be well done and the double - way central vein catheter was installed. The conditioning regimen was as follows： Carboplatin and Etoposide were intravenously infused for 24 hours, together using melphalan for 4 days. Results Chemotherapy drugs were given through the double - way central vein catheter for 4 days, and no effusions was occurred. The patients were well tolerated, but they all had infections, severe digestive tract resound, severe oral mucosa ulcer and edema, together with heavy sense of loneliness and psychological feeling. Through strengthening aseptic manipulation and paying more attention to psychological, oral and perianal nursing, all complications in 14 eases were cured, and BMTs were successful. Condusions Central vein catheter is of benefit to chemotherapy for 4 successive days. The pediatric patients using mephalan as conditioning regimen have severe complications, earnest nursing is very important to them.