护理干预对白细胞介素-11联合环孢素治疗特发性血小板减少性紫癜患者的影响

Effect of nursing intervention on idiopathic thrombocytopenic purpura patients undergoing the therapy of recombinant human interleukin-11 plus cyclosporine

目的研究护理干预对白细胞介素-11联合环孢素治疗特发性血小板减少性紫癜（1TP）患者的疗效和对生活质量的影响。方法83例糖皮质激素无效的ITP患者根据纳入顺序采用抛硬币法随机分为干预组和对照组，两组均采用白细胞介素-11联合环孢素治疗，对照组采取常规护理，干预组在此基础上进行护理干预，如体重和心率监测、心理辅导及药物指导，患者干预前、出院后采用诺丁汉健康调查问卷评价患者生活质量，疗程结束3个月后评价疗效。结果出院时，干预组患者在精力、情绪反应、睡眠、社会孤独感和身体活动能力5个方面评分[（18.7±10．3），（23．4±8．5），（24．4±7．9），（21．2±12．8），（15．7±5．7）分]均低于对照组[（27．5±10．7），（29．6±16．4），（29．7±13．4），（27．3±8．9），（19．7±9．6）分]，差异均有统计学意义（t值分别为3．81，2．21，2．23，2．47，2．34；P〈0．05）。干预组患者总有效率为95．6％，明显高于对照组的78．9％，两组比较差异有统计学意义（P=0．033）。结论护理干预结合白细胞介素-11联合环孢素治疗ITP患者，具有更好的疗效并可显著提高患者生活质量。

Objective To evaluate the effect of nursing intervention on quality of life of idiopathic thrombocytopenic purpura （ITP） patients undergoing the therapy of recombinant human interleukin-11 （rhlL- 11 ） plus cyclosporine. Methods Totals of 83 ITP patients unresponsive to corticosteroid therapy were randomly divided into intervention group and control group, all of the patients were administered with the therapy of rhIL- 11 subcutaneously and cyclosporine orally. The control group were given conventional nursing, while the intervention group received nursing intervention such as heart rate and weight monitoring, psychological service, and medicine direction. Then, quality of life was evaluated before nursing intervention and after leaving hospital by Nottingham healthy profile, the efficacy was evaluated in 3th months after the end of treatment period. Results The quality factors scores of life such as energy level（ 18.7±10.3 vs 27.5±10.7）, emotional reaction （ 23.4±8.5 vs 29.6 ± 16.4）, sleep （24.4±7.9 vs 29.7±13.4）, social isolation （21.2 ± 12.8 vs 27.3 ± 8.9 ） and physical abilities （ 15.7 ±5.7 vs 19.7±9.6） of the intervention group were significantly lower than that of the control group （ t = 3.81,2.21,2.23, 2.47,2.34, respectively; P 〈 0.05 ）. Efficacy of the intervention group was obviously higher than of the control group （95.6% vs 78.9% ; P = 0. 033）. Conclusions Nursing intervention plus rhIL-11 and cyclosporine is an effective measure for ITP patients, which could effectively improve their quality of life and the efficacy of therapy.