维甲酸联合亚砷酸、小剂量柔红霉素治疗急性早幼粒细胞白血病18例临床护理

Clinical nursing care of 18 patients with acute promyelocytic leukemia treated with Tretinoin combined with Arsenious acid and a small dose of Daunorubicin

目的:探讨维甲酸联合亚砷酸、小剂量柔红霉素治疗急性早幼粒细胞白血病(APL)的效果与护理方法。方法:将34例初治APL患者随机分为两组,维甲酸组16例,给予维甲酸治疗;联合治疗组18例,给予维甲酸、亚砷酸、小剂量柔红霉素治疗。判断两组疗效及毒副作用。结果:联合治疗组完全缓解率94.4%,较单用维甲酸组的62.5%差异有统计学意义(P<0.05);获得完全缓解中位时间30 d,与单用维甲酸组的58 d比较,差异有统计学意义(P<0.05)。联合治疗组无一例发生高白细胞综合征及维甲酸综合征。结论:维甲酸联合亚砷酸、小剂量柔红霉素治疗APL完全缓解率明显升高,达完全缓解时间明显缩短,维甲酸所致的毒副作用明显减少。

Objective ： To explore the effect of Tretinoin combined with Arsenious acid and a small dose of Daunorubicin in the treatment of acute promyelocytic leukemia （ APL ） and nursing methods. Methods ： 34 newly diagnosed APL patients were randomly divided into Tretinoin treatment group （ n = 16 ） and combined treatment group （ n = 18 ）. The patients in Tretinoin treatment group were only given Tretinoin and the patients in combined treatment group were treated with Tretinoin combined with arsenious acid and a small dose of Dannorubicin, determining the efficacy and toxicity of the treatment in both groups. Results： The complete remission rate was 94. 4% in combined treatment group and 62.5% in Tretinoin treatment group （ P 〈 0. 05 ） ; the median time to achieve complete remission was 30 days in combined treatment group and 58 days in Tretinoin treatment group （ P 〈 0.05 ）. No Hyperleukoeytic syndrome and retinoic acid syndrome occurred in combined treatment group. Conclusion ： The complete remission rate is significantly increased when Tretinoin combined with Arsenious acid and a small dose of Daunorubicin is adopted in the treatment of APL. In addition, the time to get complete remission is significantly shortened and the side effects due to retinoic acid can be decreased markedly.