护理干预在外周血造血干细胞采集中的意义

The Meaning of Nursing Intervention in Peripheral Blood Stem Cell Collection

目的探讨护理干预对外周血造血干细胞(PBSC)采集不良反应及采集细胞质量的影响。方法选择进行PBSC采集的患者86例为研究对象。分析2002年前行干细胞采集患者(38例)的不良反应,制定相应的护理对策;对此后进行干细胞采集的患者(48例)进行护理干预;比较护理未干预组与干预组不良反应发生率、干细胞采集平均次数与采集数量之间的差别。结果恐惧/焦虑、失眠、食欲下降等是干细胞采集前最常见的不良反应,其在干预组的发生率明显低于未干预组(P<0.05)。低血糖反应、手足麻木等是干细胞采集中最常见的不良反应,其在干预组的发生率明显低于未干预组(P<0.01)。与未干预组相比,经护理干预后干细胞采集的次数有所减少,采集的单个核细胞和CD34+细胞数量均增加,尽管无统计学差异。结论在PBSC采集前,给予有针对性的护理干预,可以显著减少不良反应的发生率,并且有可能减少采集的次数,提高PBSC采集的质量,为顺利进行干细胞移植奠定基础。

Objectives A discussion on side-effect and effect of cell quality from nursing intervention to peripheral blood stem cell（PBSC）.Methods 86 patients who had PBSC are selected as research objects.The side-effect of 38 patients who had stem cells collection before 2002 are analyzed,drafted related nursing countermeasures;48 patients who had stem cells collection after 2002 are having nursing intervention;having a comparison of difference of side-effect occurrence rate,the average times and number of stem cells collection between non-intervention nursing group（NING） and nursing intervention group（NIG）.Results The most common side-effect before stem cells collection is fear/anxious,insomnia and loss of appetite and etc,which occurrence rate in NIG is obvious lower than NING（P0.05）.The most common side-effect in stem cells collection is hypoglycemic reaction,numbness of hands and feet,which occurrence rate in NIG is obvious lower than NING（P0.01）.Compared to NING,the collection times of stem cells reduce after nursing intervention;the number of single nucleus cell and CD34＋ cells both increase although there is no statistic difference.Conclusions Before PBSC collection,we should have nursing intervention at purpose that not only can reduce occurrence rate of side-effect obviously and number of collection but also can improve the quality of PBSC collection for laying the foundation to stem cells transplant smoothly.