儿童白血病运用HD-MTX化疗临床护理路径的应用探讨

Study of Clinical Nursing Pathway of HD-MTX Chemotherapy in Children with Leukemia

【目的】探讨临床护理路径（CP）在综合治疗、护理白血病患几应用大剂量甲氨蝶呤（HD-MTX）化疗的临床意义和效果，规范该类患儿在治疗过程中的护理行为。【方法】将28例急性淋巴细胞白血病（ALL）患儿，运用HD-MTX化疗共104个疗程，按入院次序的前后分为试验组和对照组，每组52例次，试验组应用临床路径管理，对照组按照常规的工作模式管理，比较两组患儿的平均住院日、住院费用、感染发生率、化疗药物的毒副作用所致并发症、病人满意度。【结果】试验组患儿的平均住院日、医疗费用、感染发生率、化疗药物不良反应发生率显著少于对照组（P〈O．05）。【结论】ALL运用HD-MTX化疗时应用CP管理，是深化临床优质护理服务内涵一条切实可行的有效途径。

[Objective]To explore the clinical significance and efficacy of clinical nursing pathway（CP） of high dose methotrexate（HDMTX） chemotherapy in children with leukemia and to standardize the nursing behavior of children with leukemia during therapy. [Methods] Totally 28 pediatric patients with acute lymphoblastic leukemia （ALL） received HDMTX chemotherapy for 104 courses. According to the time of admission, all patients were di vided into experimental group and control group with 52 courses in each group. Clinical pathway management was used in the experimental group and routine management was used in the control group. The average hospitalization days, cost of hospitalization, infection rate, complications caused by adverse drug reaction and patient satisfaction were compared between two groups. [Results] The average hospitalization days, medical fees, infection rate, complications caused by adverse drug response and patient satisfaction in experimental group were lower than those in control group（ P d0.05）. [Conclusion] Application of CP management during HDMTX chemotherapy of ped iatric patients with ALL is a feasible way of deepening the connotation of high quality of clinical nursing service.