晚期原发性肝癌患者行帕博利珠单抗免疫治疗的护理

Nursing of 18 patients with advanced primary liver cancer treated with Pambrolizumab immunotherapy

目的总结晚期原发性肝癌患者行帕博利珠单抗免疫治疗的护理经验。方法18例晚期原发性肝癌使用帕博利珠单抗进行免疫治疗的患者,实施包括心理舒缓,用药前病情评估、给予抗组胺药预防过敏反应,严格按规范配置药液,药物使用中严密观察副作用的发生和护理等措施。结果18例患者均顺利完成帕博利珠单抗免疫治疗。2例患者在输注药物后30min出现低至中度发热,2例在用药后2~5d出现低度发热,1例用药第2天出现中度疲乏,2例出现轻度皮炎反应,所有患者经对症治疗和及时有效的护理,症状缓解或消失,均顺利出院。结论在晚期原发性肝癌患者行帕博利珠单抗免疫治疗中,加强病情评估、严格按规范配置和输液药液、严密观察药物不良反应和护理,对提高药物治疗效果具有积极的意义。

Objective Eighteen patients with advanced primary liver cancer who underwent immunotherapy with Pembrolizumab alone were observed and cared.Methods Nursing points included improving the condition assessment before medication,strictly arranging the drug solution according to the specifications,administering antihistamines to prevent allergic reactions before administration,improving the health education of drugs and side effects;controlling the drug solution infusion rate,in-depth observation of vital signs during the infusion process,timely detection of adverse drug reactions and treatment,attention to the patient's psychological status during hospitalization,implementation of psychotherapy for patients with advanced cancer,self-care observation guidance for drug-mediated immune inflammatory adverse reactions after discharge from hospital.Results Eighteen patients successfully completed the infusion,two patients had low to moderate fever within 30 minutes after infusion,2 patients developed low fever 2 to 5 days after administration,and 1 patient experienced moderate fatigue on the second day,2 patients with mild dermatitis reaction.All patients were discharged smoothly with symptom relief or disappearance after supportive treatment.Conclusion In the immunotherapy with papolizumab for patients with advanced primary hepatocellular carcinoma,it is of positive significance to enhance the efficacy of drug therapy by strengthening the condition evaluation and strictly observing the adverse drug reactions and nursing in strict accordance with the standard configuration and infusion solution.