探讨大剂量甲氨蝶呤治疗ALL的临床护理措施

To explore the clinical nursing measures of high dose methotrexate in the treatment of ALL

目的:探讨大剂量甲氨蝶呤(HD-MTX)治疗急性淋巴细胞白血病(ALL)临床护理措施的临床效果。方法:选取某医院的84例ALL患者,随机分为对照组和试验组。对照组患者采用常规护理,在此基础上试验组患者加用综合护理干预。比较两组患者的血清MTX浓度和四氢叶酸钙(CF)总需要量,并比较不良反应发生率。结果:两组患者化疗后0h和20h的MTX血清浓度及骨髓抑制、肝功肾功等不良反应差异无统计学意义(P>0.05),试验组患者44h MTX浓度、CF需要量以及消化道症状和口腔溃疡发生率小于对照组(P<0.05)。结论:对大剂量甲氨蝶呤治疗ALL的患者采取综合护理干预可以降低MTX血清浓度、CF解救量以及不良反应发生率,值得临床推广。

Objective：Sudy the elinieal effect of implementing clinical nursing measures to high dose methotrexate （HD-MTX） in the treatment of acute lymphoblastic leukemia （ALL）. Methods： Chose 84 cases of patients diagnosed with ALL from Hospital, they were randomly divided into control group and experimental group. Control group using conventional care,on the basis of experimental group add in comprehensive nursing intervention. Compared the serum MTX concentration,calcium tetrahydrophosphate （CF） total requirement and the incidence of adverse reactions. Results： There were no significant differences in the levels of MTX serum after chemotherapy at Oh and 20h ,myelosuppression, liver function and kidney function between the two groups （P〉 0.05）. The MTX levels of 44h, CF requirement and incidence of digestive tract symptoms and oral ulcer were lower in the test group than in the control group （P〈 0.05）.Conclusion： Comprehensive nursing intervention can reduce the level of MTX, the amount of CF and the incidence of adverse reactions in patients with ALL methotrexate treatment. It is worthy to be promoted.