白血病化疗后并发卡氏肺孢子菌肺炎的临床观察和护理经验

Clinical Observation on the Leukemia Combined with Pneumocystis Carinii Pneumonia after Chemotherapy and the Nursing Experiences

目的：观察白血病化疗后并发卡氏肺孢子菌肺炎（PCP）的临床表现并总结其护理经验。方法回顾性分析我科2010年7月-2013年7月收治的7例白血病并发PCP患者的临床资料，总结其临床表现、治疗经过和护理要点。结果4例白血病合并PCP的患者经积极治疗和护理后好转，继续接受化疗，其中3例目前仍在化疗中，1例初次治疗后好转，在之后的两次化疗中均再次感染PCP，最终死于呼吸衰竭。3例感染控制后出院，未再行化疗，目前在康复中。结论白血病患者化疗后并发PCP时，主要表现为胸闷、干咳、不同程度的发热及进行性呼吸困难，X线和CT检查具有一定的辅助诊断意义。护理时应密切观察患者的各项生命体征、药物不良反应和口腔黏膜的变化，做好保护性隔离，预防交叉感染，并进行针对性心理干预以缓解患者症状。

Objective To observe the clinical manifestations of cartesian pneumocystis pneumonia （PCP） of leukemia pa-tients after chemotherapy and summarize the nursing experience. Methods The clinical data of 7 cases of leukemia patients with concurrent PCP in our department between July 2010 and July 2013 were retrospectively analyzed, and their clinical manifesta-tion, treatment and nursing key points were summarized here. Results After active treatment and nursing, four leukemia patients with PCP turned better and continued chemotherapy, of which three continued chemotherapy till now, but one got PCP infection again in later two courses of chemotherapy and finally died of respiratory failure. Three cases of infection were controlled and left hospital with no chemotherapy, and now in the rehabilitation. Conclusion Leukemia patients with concurrent PCP after chemotherapy had the main manifestations like chest tightness, dry cough, different degrees of fever and progressive difficulty in breathing. Auxiliary diagnosis of X-ray and CT examination had certain significance. Nursing care should include close obser-vation on the patient’s vital signs, adverse drug reactions and change of oral mucosa, as well as protective isolation, prevention of cross infection, and targeted psychological intervention to relieve symptoms.