大剂量氨甲蝶呤治疗急性白血病时的护理措施及体会

The nursing measures in acute leukemia patients treated with high dose methotrexatum

目的 探讨大剂量甲氨蝶呤治疗急性白血病时的护理措施。方法 对 18例急性白血病患者进行了 2 6例次大剂量氨甲蝶呤 (HD MTX 1～ 1.5g/m2 )治疗护理观察。结果 我们认为 ,HD MTX治疗患者对该治疗的副反应主要是口腔粘膜炎症 ,肝功能损害和感染。口腔护理效果在口腔粘膜炎症出现前进行比出现口腔粘膜炎症后再进行的好。若同时进行水化疗法、碱化尿液和防治感染则效果会更好。治疗前做好患者的心理工作也是确保取得良好疗效的必要措施之一。结论 通过护理观察 ,我们体会到 ,HD MTX治疗患者在进行治疗的同时进行口腔护理并进行水化疗法和碱化尿液及防治感染 ,对于HD MTX治疗的患者所出现的副反应有一定的预防作用。

Objective:To study the nursing measures of acute leukemia treated with high dose methotrexatum(HD MTX). Methods: Fourteen cases of patients with acute leukemia treated with HD MTX(1 0～1 5 g/m 2) were observed. Results: we found that oral mucositis, liver lesion and infection were major side effects in these pations. The effect of oral nursing taken before the appearance of oral mucositis was better than that after the appearance of oral mucositis. If we used hydrated therapy, urinary basification and anti infective at the same time, the effect would be more satisfactory. Psychotherapy before the treatment was also necessary to ensure the satisfactory result. Conclusion: Through our observations, we think that oral nursing, hydrated therapy, urinary basification and anti infective in acute leukemia patients using HD MTX will decrease the incidence of side effects.