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目的探讨学龄前儿童造血干细胞移植极期的护理特点及难点,总结临床护理经验。方法选择本科2009-2015年期间,年龄为1岁7月-5岁3月的36例行造血干细胞移植术的患儿为研究对象,回顾性地分析36例患儿在移植极期出现的并发症(病毒细菌感染、皮肤黏膜损伤、全身大片皮疹、血尿等),结合患儿特点护理(导管护理、输液速度控制、心理生理特点、防跌倒坠床),总结患儿移植极期的护理特点及难点,并提出个性化地的护理措施。结果 36例患儿均发生并发症,程度不一,有21例(58.3%)发生多种并发症;3例患儿发生非计划性拔管;1例患儿出现急性左心衰竭死亡;无1例患儿发生跌倒、坠床不良事件。结论熟练掌握患儿移植极期易出现的并发症及患儿特点护理,对造血干细胞移植患儿有针对性的进行个体化地护理,是确保患儿移植成功的关键。
Objective To explore the characteristics and difficulties of the nursing care of preschool children during the period of hematopoietic stem cell transplantation and to summarize the experience of clinical nursing. Methods Thirty-six children undergoing hematopoietic stem cell transplantation between the ages of 1 year and 7 months and 5 years from 2009 to 2015 were enrolled in this study. Retrospective analysis was performed on the incidence of complications (Viral bacterial infections, mucocutaneous lesions, generalized large rash, hematuria, etc.), combined with the characteristics of children care (catheter care, infusion speed control, psychological and physical characteristics, fall prevention bed) And difficulties, and propose personalized care measures. Results Complications were found in 36 children with varying degrees. There were 21 cases (58.3%) with various complications, 3 cases with unplanned extubation, 1 case with acute left heart failure, and none One patient had a fall and a bed fall adverse event. Conclusions It is very important to understand the complications that occur in the polar region and the characteristics of the children in the transplant. It is the key to ensure the success of transplantation in children with hematopoietic stem cell transplantation.