老年恶性血液肿瘤合并其他脏器肿瘤的临床护理问题及对策

Clinical care issues and strategies of the elderly malignant blood cancer complicated by multiple organ cancer

目的 分析老年恶性血液肿瘤合并其他脏器肿瘤患者的护理问题,探讨护理对策.方法 回顾总结在对19例老年恶性血液肿瘤合并其他脏器肿瘤患者的护理中遇到的临床问题及处理经验.结果 19例患者均出现不同程度的精神症状（全部存在睡眠障碍,2例明确诊断抑郁症）,11例出现感染,5例出现营养不良,9例出现皮肤问题（不同程度淤点、淤斑）,10例出现癌性疼痛,8例出现大便形态及次数的改变（腹泻、便秘）,19例留置管道（1例留置胸腔引流管、1例留置腹腔引流管、1例同时留置胸腹腔引流管、3例留置大静脉管、16例留置PICC管、1例留置直肠造瘘口）.此组患者在得到有针对性的护理措施后,生活质量得到改善,生命得到了延长.结论 通过分析总结老年恶性血液肿瘤合并多脏器肿瘤患者的临床护理问题,提供优质的身心整体相结合的护理干预措施,使患者积极配合治疗,取得良好的效果,提高了其生存质量.

Objective To analyze the clinical care issues of the elderly malignant blood cancer and figure out the strategies. Methods Review and summarize clinical care issues during the care of 19 elderly patients with malignant blood cancer. Results All the patients had various degrees of psychiatric symptoms （all had sleep disorders, 2 cases of diagnosed depression）, 11 cases of infection, 5 cases of malnutrition, skin problems occurred in 9 cases （various degrees of petechia, ecchymosis）, 0 patients had cancer pain, 8 patients had the changes of the form and frequency stool （diarrhea, diarrhea） , 1 patient with chest drainage tube, 1 patient with abdominal drainage tube, 1 patient with chest and abdominal drainage tube, 3 patients with large venous tube, IS patients with PICC tube, 1 case with enterostomy. Through targeted clinical care measurements, the life quality of the patients was greatly improved and the life year was extended. Conclusions During the clinical care of 19 elderly patients with malignant blood cancer, we provided the intervention measurements characterized by the combination of physiology and psychology. These measures had made the patients actively cooperate with the treatment and improved their quality of life.