多发性骨髓瘤病人合并肾衰竭行血液透析治疗期间皮下注射硼替佐米的护理

The nursing of subcutaneous injection of bortezomib therapy during hemodialysis for multiple myeloma combined with renal failure

[目的]总结多发性骨髓瘤病人合并肾衰竭行血液透析治疗期间皮下注射硼替佐米的护理。[方法]对5例多发性骨髓瘤合并肾衰竭病人在行血液透析治疗同时予硼替佐米皮下注射联合地塞米松化疗,合理安排给药时间,治疗期间重视心理护理、血液透析导管的护理、用药护理、药物不良反应的护理等。[结果]完全缓解3例,部分缓解1例,因病情进展放弃治疗1例,其中最早1例入院病人肾功能恢复接近正常脱离血液透析治疗;出现的不良反应主要有外周神经病变、胃肠道反应、骨髓抑制、乏力。[结论]硼替佐米皮下注射治疗多发性骨髓瘤合并肾衰竭有较好疗效,严密观察不良反应并予及时处理,可保证病人顺利完成治疗,促进病人康复。

Objective：To summarize the nursing of subcutaneous injection of bortezomib therapy during hemodialysis for multiple myeloma patients combined with renal failure.Methods：Five patients with multiple myeloma combined with renal failure were treated by subcutaneous bortezomib with dexamethasone chemotherapy simultaneously during hemodialysis.To arrange the reasonable administration time and pay attention to psychological care,hemodialysis catheter care,administration treatments,adverse drug reactions and other care.Results：3cases were complete remission,1case was partial remission,and 1case gave up treatment.The adverse reactions mainly included peripheral neuropathy,gastrointestinal reactions,bone marrow suppression,and fatigue.Conclusion：Bortezomib subcutaneous treatment has a good effect on multiple myeloma patients combined with renal failure.Ensured a close observation and in-time treatment of adverse reactions,the patients could complete the treatment and promote the rehabilitation successfully.