120例胃癌患者免疫检查点抑制剂不良反应分析及护理对策

Adverse Drug Reactions of Immune Checkpoint Inhibitors in 120 Gastric Cancer Patients and Nursing Strategies

目的回顾性分析120例胃癌患者免疫检查点抑制剂治疗后的不良反应,并探讨相应的护理对策。方法120例胃癌患者均接受帕博利珠单抗治疗,住院期间观察不良反应发生情况,并提出护理预防对策;出院后随访6个月,统计不良反应发生率。结果120例患者中有74例发生免疫相关不良反应,其中全身性毒性24例(20.00%),胃肠道毒性8例(6.67%),内分泌系统毒性5例(4.17%),免疫相关性肺炎2例(1.67%),肝毒性9例(7.50%),皮肤毒性25例(20.83%),心脏毒性1例(0.83%)。1级不良反应60例,2级不良反应13例,无3级不良反应,4级不良反应1例。结论帕博利珠单抗的不良反应分布广泛,但多为1~2级不良反应,严重不良反应罕见,给予相应的护理策略可缓解。

Objective To retrospectively analyze the adverse drug reactions(ADRs)of 120 gastric cancer patients treated with immune checkpoint inhibitors,and to investigate the corresponding nursing strategies.Methods A total of 120 patients with gastric cancer were treated with pembrolizumab.The ADRs were observed during hospitalization,and the nursing and preventive measures were proposed.All patients were followed up for six months after discharge,and the incidence of ADRs was calculated.Results Seventy-four of 120 patients had immune-related ADRs,including 24 cases of systemic toxicity(20.00%),eight cases of gastrointestinal toxicity(6.67%),five cases of endocrine system toxicity(4.17%),two cases of immune-related pneumonia(1.67%),nine cases of hepatotoxicity(7.50%),25 cases of dermal toxicity(20.83%),one case of cardiac toxicity(0.83%).There were 60 cases of grade 1 ADRs,13 cases of grade 2 ADRs,no grade 3 ADRs,and one case of grade 4 ADRs.Conclusion The ADRs of pembrolizumab are widely distributed,but most of them are grade 1 to 2 ADRs.Serious ADRs are rare,and can be alleviated by corresponding nursing strategies.