预见性干预在鞘内化疗预防小儿中枢神经系统白血病的临床应用
摘要
目的探讨预见性干预在鞘内化疗预防小儿中枢神经系统白血病的临床应用及效果。方法选取解放军总医院第七医学中心2011年1月至2018年6月收治的白血病患儿120例,按随机数字表法将患儿分为试验组和对照组各60例,试验组患儿在鞘内化疗前后给予预见性干预,对照组患儿给予常规干预。观察并记录两组患儿穿刺成功率、疼痛发生情况、不良反应发生率、治疗依从性、家属满意度等方面的临床数据。结果预见性干预与常规干预方法在鞘内化疗预防小儿中枢神经系统白血病的穿刺成功率、疼痛控制、依从性、家属满意度方面,差异有显著性;不良反应率比较差异无显著性。结论鞘内化疗是预防中枢神经系统白血病的必要操作之一,实施预见性干预虽不降低不良反应发生率,但可有效提高白血病患儿鞘内化疗治疗的穿刺成功率、治疗依从性及家属满意度,有效缓解疼痛。
引文
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[10]Ali A,Kalla A.Multiple cranial nerve palsies in immunodeficiency subtype of Burkitt lymphoma[J].Community Hosp Intern Med Perspect,2018,8(5):303-306.
[11]Kang XH,Bao FP,Xiong XX,et al.Major complications of epidural anesthesia:a prospective study of 5083 cases at a single hospital[J].Aaesthesiol Scand,2014,58(7):858-866.
[2]庞静玲,吴涛,白海.治疗相关性白血病的研究进展[J].中国医刊,2017,52(12):36-39.
[3]罗玉辉,杨志军,刘会长.老年患者腰硬联合麻醉下全髋关节置换术中应用右美托咪定鞘内注射的临床效果观察[J].中国医刊,2018,53(9):1003-1006.
[4]中华医学会儿科学分会血液学组.儿童髓细胞白血病诊疗建议[J].中华儿科杂志,2006,44(11):877-878.
[5]伍曼仪,黄绍良.现代小儿血液病学[M].福州:福建科学技术出版社,2002:338.
[6]lannalfi A,Bemini G,Caprilli S,et al.Painful procedures in children with cancer:comparison of moderate sedation and general anesthesia for lumbar puncture and bone marrow aspiration[J].Pediatr Blood Cancer,2005,45(7):933-938.
[7]严伟玲,窦珍珍,陈天明,等.儿童腰椎穿刺后平卧时间长短对并发症的影响[J].中华实用儿童临床杂志,2014,29(12):914-918.
[8]Lowery S,Oliver A.Incidence of postdural puncture headache and backache following diagnostic/therapeutic lumbar puncture using a22G cutting spinal needle,and after introduction of a 25G pencil point spinal needle[J].Paediatr Anaesth,2008,18(3):230-234.
[9]Davignon KR,Dennehy KC.Lpdate on postdural puncture headache[J].Int Anesthesiol Clin,2002,40(4):89-102.
[10]Ali A,Kalla A.Multiple cranial nerve palsies in immunodeficiency subtype of Burkitt lymphoma[J].Community Hosp Intern Med Perspect,2018,8(5):303-306.
[11]Kang XH,Bao FP,Xiong XX,et al.Major complications of epidural anesthesia:a prospective study of 5083 cases at a single hospital[J].Aaesthesiol Scand,2014,58(7):858-866.