肿瘤患儿鞘内注射后不同平卧时间并发症发生情况及依从性研究

Study on complications and compliance of different lying time after intrathecal injection in children with leukemia

目的调查肿瘤患儿鞘内注射后不同平卧时间并发症发生情况以及患儿的依从性。方法选择首都医科大学北京儿童医院血液肿瘤日间病房2017年4月1日至2019年3月28日进行鞘内注射的553例患儿为研究对象。将2017年4月1日至12月31日进行鞘内注射的274例设为对照组,鞘内注射后去枕平卧4 h;选择2018年1月1日至2019年3月28日进行鞘内注射的279例设为试验组,鞘内注射后去枕平卧2 h。观察2组鞘内注射后去枕平卧期间以及1周内并发症发生情况。结果研究期间553例患儿符合排除标准被排除,最终457例患儿纳入本研究,其中对照组222例,试验组235例。试验组去枕平卧期间肢体麻木和局部压红的例数分别为18例和20例,对照组分别为31例和34例,2组比较差异有统计学意义(χ^(2)值为4.74、5.07,P<0.05);鞘内注射后患儿对去枕平卧时间的依从性,试验组完全能接受、比较能接受、能接受、需努力坚持的例数分别为65、83、42、45例,对照组分别为34、50、76、62例,2组比较差异有统计学意义(χ^(2)值为30.04,P<0.05)。结论肿瘤患儿鞘内注射后去枕平卧2 h可降低并发症发生率,提高依从性,安全可行,不影响疾病预后。建议儿童患者鞘内注射后去枕平卧2 h。

Objective To investigate the complication and compliance of different supine time and the degree of obedience in children with leukemia after intrathecal chemotherapy.Methods A total of 553 children with leukemia after intrathecal chemotherapy from April 1,2017 to March 28,2019 in Beijing Children′s Hospital Affiliated to Capital Medical University were selected.Children who received intrathecal injection from April 1,2017 to December 31,2017 were selected as control group(274 cases),from January 1,2018 to March 28,2019 were selected as research group(279 cases).The children in research group were supine 2 hours but control group were supine 4 hours after intrathecal.The complications that occurred after injection and within one week after injection and compliance were observed.Results Finally,457 children included in this study,there were 235 cases in research group and 222 cases in control group.The number of cases of limb numbness and local pressure reddening in the research group and the control group were 18,20 and 31,34,respectively,with statistically significant differences between the two groups(χ^(2) values were 4.74,5.07,P<0.05).After intrathecal injection,the patients'compliance with the time of supine removal was completely acceptable to the research group,relatively acceptable,acceptable,and required efforts to adhere to the number of cases were 65,83,42,45,respectively,while the control group were 34,50,76,62,respectively,the differences were significant(χ^(2) value was 30.04,P<0.05).Conclusions Supine for 2 hours after intrathecal injection can reduce the incidence of complications and improve compliance,which is safe and feasible.So,supine for 2 hours after intrathecal injection is recommended.