摘要
目的总结156例口服普萘洛尔联合马来酸噻吗洛尔滴眼液外涂治疗婴幼儿血管瘤的护理经验。方法用药前后对患儿家属进行健康宣教及心理护理,指导家属观察患儿用药后反应,住院期间监测患儿血糖、血压、心率、呼吸及心电图情况,及时发现并干预不良反应,出院后定期随访,监督家属遵医嘱给患儿服用药物,通知家属携带患儿按时复诊,以便能及时根据患儿体重、病情等调整剂量。结果本组患儿用药后24 h均出现血管瘤颜色变浅,体积不同程度的缩小; 7例患儿因用药后1个月反复出现轻微咳嗽伴有吼喘症状,完善肺功能检查提示轻-中度气道高反应,予以停止用药; 5例因用药后出现心率减慢、睡眠障碍、腹泻,家长担心影响发育自行停药后复发;其余患儿用药6个月后瘤体基本消失,给予停药。结论口服普萘洛尔联合马来酸噻吗洛尔滴眼液外涂治疗婴幼儿血管瘤疗效明显,不良反应轻。用药期间剂量的掌握、瘤体及药物不良反应的观察、耐心细致的护理,良好的护患沟通对患儿的康复至关重要。
Objective To summarize the nursing experience of 156 cases of infantile hemangioma treated with oral propranolol combined with Timolol Maleate Eye Drops. Methods Before and after treatment to the families of children with health education and psychological nursing,guiding families were observed after drug reaction,blood glucose monitoring during hospitalization,blood pressure,heart rate,respiration and ECG,the timely discovery and intervention of adverse reactions after discharge,regular follow-up,supervision of family doctor＇s advice to the children taking drugs,notify the family to carry children timely referral,in order to promptly according to the weight of the patients,the disease such as dose adjustment. Results This group of children after 24 h showed hemangioma pale,the volume of different degrees of narrowing; 7 cases with medication 1 months after repeated mild cough with wheezing symptoms,improve lung function examination showed mild to moderate airway hyperresponsiveness,to stop medication; 5 cases with medicine after heart rate slow down,sleep disorders,diarrhea,parents worry that affect the development of recurrence after discontinuation of self medication in children; the rest 6 months after the tumor disappeared,giving withdrawal. Conclusion Oral propranolol combined with Timolol Maleate Eye Drops in the treatment of infantile hemangioma has obvious curative effect,and the side effects are mild. During the period of medication,the dose control,the observation of tumor and adverse drug reactions,patient and meticulous care,good nurse patient communication are crucial to the rehabilitation of children.
作者
谢帅
郭军
XIE Shuai;GUO Jun(Department of Pediatrics,Central Hospital of Mianyang,Mianyang 621000,China)
